三种抗原检测抗幽门螺杆菌抗体的临床意义评价

干小仙　丁建祖　沈慧英　沈丽英　陈一平

　　中国图书分类号　R392-33
　　摘　要　目的：寻求敏感性高、特异性强的HP抗原和简便、可靠的检测HP抗体的方法，用于诊断HP感染。方法：分别以HP尿素酶、全菌破碎物、培养上清液为抗原。采用斑点金标免疫渗滤法(DIGFA)检测HP培养、病理组织学检查、尿素酶试验均阳性和均阴性的血清各50份；胃镜检查各类胃病患者血清258份，并以ELISA试剂盒做平行检测对照。结果：三种抗原的敏感性分别为100%、96%和76%；50份阴性血清的阴性符合率分别为98%、92%和64%；258份各类胃病的抗体检出率分别为61%、62%和52%；与ELISA符合率各为98.8%、96.5%和58.9%。将抗原浓度稀释至0.05 mg/ml时，尿素酶抗原和全菌破碎物抗原的特异性抗体检出率仍达85%和75%。培养上清液抗原的敏感性和特异性明显低于前二种抗原(P＜0.01)。尿素酶抗原和全菌破碎抗原的敏感性和特异性明显低于前二种抗原(P＞0.05)。结论：提示该全菌破碎物抗原用于DIGFA检测HP抗体、敏感性高、特异性强，且简便、快速、无需任何仪器设备。适合于临床和流行病学调查应用。
　　关键词　幽门螺杆菌　抗原　斑点金标免疫渗滤法

Evaluation on the clinical diagnosis of various HP antigens for detection of anti-HP antibodies by DIGFA

GAN Xiao-Xian，DING Jian-Zu， SHEN Hui-Ying et al .
Institute of Parasitic Diseases,Zhejiang Academy of Medical Sciences,Hangzhou 310013

Abstract　Objective:To select available Helicobacter pylori(HP)antigens and develop a simple and reliable assay for detection of HP infection,with high sensitivity and specificity.Methods:Urease,crude abstract of whole HP,supernatant of HP culture were used as antigens to detect anti-HP antibodies in serum by Dot Immunogold Filtration Assay(DIGFA).50 sera from patients infected with HP,50 sera from normal adult and 258 sera from out-patients with various stomach troubles were tested using three antigens by DIGFA,respectively and paralleled with results of ELISA kit.Results:Sensitivities of three antigens were 100%,96% and 76%,specificities of them were 98%,92% and 64%,respectively.Positive rates of 258 sera from out-patients were 61%,62% and 52% when detected using three antigens.Coincidental rate with ELISA were 98.8%,96.5% and 58.9%,when the concentration of antigens was 0.05 mg/ml,the positive predictive rates using urease,crude abstract antigens were still as high as 85% and 75%.The sensitivity and the specificity of supernatant of HP culture antigen were significantly lower than those of urease antigen and crude abstract antigen(P＜0.01)

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