三种幽门螺旋杆菌检测方法对临床消化道相关疾病的诊断价值评估

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摘要目的评价三种幽门螺旋杆菌检测方法对临床消化道相关疾病的临床应用价值。方法对2017年1～12月于北京地坛医院就诊的177例患者，采用C-尿素呼气试验（13C-UBT）法检测幽门螺旋杆菌，同时抽取静脉血采用快速胶体金法及免疫印迹法检测幽门螺旋杆菌，以13C-UBT检测方法作为金标准，对胶体金法和免疫印迹法的检测结果进行对比分析。结果 177例就诊患者13C-UBT检测阳性106例，阴性71例。其中106例13C-UBT阳性患者中快速胶体金法检测阳性100例，阴性6例。其敏感度为94.3%，特异性为83.1%；阳性预测值为89.3%，阴性预测值为90.8%。106例13C-UBT阳性患者中免疫印迹法检测阳性102例，阴性4例。其敏感度为96.2%，特异性为84.5%；阳性预测值为90.3%，阴性预测值为93.8%。两种方法差异无统计学意义（P ＞ 0.05）。147例不同消化道疾病患者采用免疫印迹法检测，其中Ⅰ型66例（44.9%）、Ⅱ型20例（13.61%），两种分型差异有高度统计学意义（χ2 = 34.778，P = 0.000）。胃十二指肠溃疡、慢性胃炎患者幽门螺旋杆菌Ⅰ型、Ⅱ型比较，差异有统计学意义（P ＜ 0.05）；反流性食管炎患者幽门螺旋杆菌Ⅰ型、Ⅱ型比较，差异无统计学意义（P ＞ 0.05）。结论快速胶体金检测法与幽门螺旋杆菌现症感染高度相关，适用于幽门螺旋杆菌感染的初筛，而免疫印迹法可以进行毒力分型，更适用于临床药物治疗的选择。

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	焦炳欣* 郭杰* 徐新民何艳群周淳李坪张桂芳

关键词 ：幽门螺旋杆菌, 快速胶体金检测法, 免疫印迹法, Ⅰ型菌株, Ⅱ型菌株

Abstract：Objective To evaluate three diagnostic methods for detecting Helicobacter pylori (Hp) infection in clinical digestive tract related diseases. Methods A total of 177 cases treated in Beijing Ditan Hospital from January 2017 to December 2017 were collected, the Hp was detected via C-urea breath test (13C-UBT), rapid colloidal gold and Western blot methods. 13C-UBT method was used as golden standard and rapid colloidal gold and Western blot methods were compared in the sensitivity and specificity. Results Of the 177 cases, 106 cases were positive in 13C-UBT test, 71 cases were negative. Among 106 cases of 13C-UBT positive patients, 100 cases were positive in colloidal gold assay method and 6 cases were negative. The sensitivity rate was 94.3% and the specificity rate was 83.1%; the positive predictive value was 89.3% and the negative predictive value was 90.8%. Among 106 cases of 13C-UBT positive patients, 102 cases were positive and 4 cases were negative by the method of Western blot method. The sensitivity rate was 96.2%, specificity rate was 84.5%; the positive predictive value was 90.3% and the negative predictive value was 93.8%. There was no significant difference between the two methods (P ＞ 0.05). There were 147 cases of different gastrointestinal diseases were detected by the method of Western blot, of which 66 cases were type Ⅰ, accounting for 44.9%; type Ⅱ 20 cases, accounting for 13.61%. There was a significant difference between the two subtypes (χ2 = 34.778, P = 0.000). The subtypes distribution of Hp, type Ⅰ and Ⅱ had a significant difference between gastroduodenal ulcer and chronic gastritis (P ＜ 0.05), while the distribution in reflux esophagitis had no difference (P ＞ 0.05). Conclusion The rapid colloidal gold method is highly correlated with the infection of Hp and is suitable for the preliminary screening of Hp infection. However, the method of Western blot can be used for toxicity typing and is more suitable for the choice of clinical drug treatment.

Key words： Helicobacter pylori Rapid colloidal gold detection Western blot Type Ⅰ strain Type Ⅱ strain

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焦炳欣* 郭杰* 徐新民何艳群周淳李坪张桂芳. 三种幽门螺旋杆菌检测方法对临床消化道相关疾病的诊断价值评估[J]. 中国医药导报, 2018, 15(22): 146-149.
JIAO Bingxin* GUO Jie* XU Xinmin HE Yanqun ZHOU Chun LI Ping ZHANG Guifang. Diagnostic evaluation of three methods for detecting Helicobacter pylori in clinical digestive tract related diseases. 中国医药导报, 2018, 15(22): 146-149.

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