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目的比较儿科消化专业临床常用的几种H·pylori诊断方法的准确性,并对新的快速血液学诊断法作考核和评价。方法对2004-12—2005-03上海交通大学医学院附属瑞金医院儿内消化专科门诊100例3~16岁患儿做胃镜检查、13C-UBT、胃镜检查时在胃窦部取黏膜组织作尿素酶试验、组织学检查,并同时抽血做H·pylori抗体测定。结果100例患儿中,55例感染H·pylori(感染率为55%),尿素酶、组织学、13C-UBT、血金标法的敏感性分别为:81·48%、75·93%、96·30%、94·50%,特异性为86·96%、80·43%、100%、91·11%。金标法血清与全血测定结果显示敏感性、特异性几乎相同。结论尿素酶试验和组织学检查能直接检测胃黏膜中的H·pylori,有较高的敏感性与特异性,但需经胃镜取胃黏膜才能完成。13C-UBT能反映全部胃黏膜的感染情况,敏感性、特异性最高,是目前临床诊断的金标准之一,且非侵入性。血液金标法检测,操作方便,仅需1滴血,便可反映出H·pylori的感染状况,可作为H·pylori的流行病学检查及筛查。
Objective To compare the accuracy of several H · pylori diagnostic methods commonly used in pediatric digestive diseases and evaluate and evaluate the new rapid hematological diagnostic method. Methods From December 2004 to March 2005, 100 children aged 3 to 16 years old with endometriosis in Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine underwent gastroscopy. Gastroscopy was performed on 13C-UBT, Enzyme test, histological examination, and at the same time blood samples were taken for H. pylori antibody test. Results Among 100 cases of children, the sensitivity of 55 cases infected with H.pylori (infection rate was 55%), urease, histology, 13C-UBT and blood gold standard were 81.48% and 75.93% , 96 · 30%, 94 · 50%, specificity of 86 · 96%, 80 · 43%, 100%, 91 · 11%. Gold standard method serum and whole blood test results show the sensitivity, specificity is almost the same. Conclusion urease test and histological examination can directly detect H. pylori in gastric mucosa, which has high sensitivity and specificity. However, gastric mucosa should be taken by gastroscopy. 13C-UBT can reflect all the gastric mucosal infection, the highest sensitivity and specificity, is currently the gold standard for clinical diagnosis, and non-invasive. Blood gold standard test, easy to operate, just a drop of blood, can reflect the H. pylori infection, can be used as H. pylori epidemiological examination and screening.