�论著���通信作者:谢贤和,Email:xiexianhe_2006@yahoo.com.cn幽门螺旋杆菌5种检测方法比较何周桃,谢贤和,韦�红,蓝�程(海南省人民医院消化内科,海南海口570311)��摘�要:目的�通过对5种幽门螺旋杆菌(Hp)检测方法的比较,寻求敏感性及特异性高、快速简便的Hp检测方法,促进Hp感染的早期诊断及治疗。方法�对最近1个月内未使用过抗生素、质子泵抑制剂、H2受体阻滞剂等可能影响Hp检测结果的95例患者同步完成快速尿素酶试验(RUT)、细菌培养、13C�尿素呼气试验(13C�UBT)、血清学(幽门螺杆菌抗体HpIgG)检查、Hp病理组织学检测等检查,以细菌培养、病理组织学检测中任何1项阳性为Hp感染阳性为诊断标准,比较RUT、细菌培养、13C�UBT、HpIgG检查、Hp病理组织学检测5种检测方法检出的敏感度及特异度。结果�敏感度以RUT最高(95.7%),其次为病理组织学(87.5%)、细菌培养(82.9%)、13C�UBT(78.1%),最低为HpIgG(43.9%)。特异度由高及低依次为细菌培养(96.3%)、13C�UBT(91.4%)、病理组织学(89.7%)、HpIgG(70.4%)、RUT(65.7%)。RUT检测、13C�UBT、病理组织学检测、细菌培养的敏感度与HpIgG检测的敏感度比较差异有统计学意义(P<0.01),而RUT、病理组织学、细菌培养、13C�UBT检测的敏感度4者间差异无统计学意义(P>0.05)。RUT检测的特异度与13C�UBT检测、病理组织学检测、细菌培养的特异度比较差异有统计学意义(P<0.01),13C�UBT检测的特异度与HpIgG检测的特异度相比差异有统计学意义(P<0.01),而病理组织学、细菌培养、13C�UBT检测的特异度组间差异无统计学意义(P>0.05)。结论�13C�UBT检测的敏感度及特异度均较高,更能反映Hp感染的变化状况,可作为临床诊断Hp的首选方法。关键词:螺杆菌,幽门;诊断技术和方法;敏感性与特异性中图分类号:R573.9�文献标识码:A�文章编号:1004�583X(2011)07�0570�07ComparisonoffivemethodsforHelicobacterpylorusdetectionHEZhou�tao,XIEXian�he,WEIHong,LANGChengDepartmentofDigestion,HainanProvincialPeople�sHospital,Haikou570311,ChinaCorrespondingauthor:XIEXian�he,Email:xiexianhe_2006@yahoo.com.cnABSTRACT:Objective�WiththecomparisonoffivemethodsforHelicobacterpylorus(Hp)detection,tryingtoseekhigh,fastandsimplewaysintestingthesensitivityandspecificity,thustoimprovetheearlydiagnosisandtreatment.Methods�Thecomparisonwasmadewith95patientswhowithinonemonthhadneverappliedantibiotics,protonpumpinhibitors,H2�receptorblockersreceptorwhichmightaffecttheresultsofHpdetection.Thesepatientsfinishedsimultaneouslythedetectionofrapidureasetest,bacteriaculture,13C�ureasebreathtest,HpIgGantibodytest(HpIgG),histopathologyexamination.AnypositiveresulteitherfrombacteriacultureorhistopathologyexaminationwouldbetakenasthecriteriainthediagnosisofHpinfection.Thecomparisondatainthesensitivityandspecificityfromthefivedetectingmethodswereevaluated.Results�Thehighestsensitivitywasrapidureasetest95.7%,histopathologyexaminationwasrankedthesecond87.5%,bacteriaculturewas82.9%,13C�ureasebreathtestwas78.1%,thelowestwasHpIgGantibodytest43.9%.Thecomparisonresultofspecificityfromhightolowwasasfollows:bacteriaculture96.3%,13C�ureasebreath91.4%,histopathologyexamination89.7%,HpIgGantibodytest70.4%,rapidureasetest65.7%.Thesensitivityofrapidureasetest,13C�ureasebreathtest,histologyexamination,bacteriacultureweresignificantlydifferentfromthatofHpIgGantibodytest(P<0.01),whilethesensitivitiesinrapidureasetest,histopathologyexamination,bacteriaculture,13C�ureasebreathtestwerenosignificantdifference(P>0.05).Thespecificityofrapidureasetestwassignificantlydifferentfromthatof13C�ureasebreathtest,histopathologyexamination,bacteriaculture(P<0.01).Thespecificityof13C�ureasebreathtestwasalsodifferentfromthatofHpIgGantibodytes...
