吉林医学
吉林醫學
길림의학
JILIN MEDICAL JOURANL
2014年
33期
7342-7345
,共4页
谭鹤龙%刘兵%王引芳%周秀琴%印德民%裴中美
譚鶴龍%劉兵%王引芳%週秀琴%印德民%裴中美
담학룡%류병%왕인방%주수금%인덕민%배중미
质子泵抑制剂%幽门螺杆菌%快速尿素酶法%病理组织切片染色%粪便抗原%阳性率
質子泵抑製劑%幽門螺桿菌%快速尿素酶法%病理組織切片染色%糞便抗原%暘性率
질자빙억제제%유문라간균%쾌속뇨소매법%병리조직절편염색%분편항원%양성솔
Proton pump inhibitors(PPI)%Helicobacter pylori(Hp)%Fast urease test(FUT)%Tissue staining%stool antigen test%Positive rate
目的：通过对短期应用质子泵抑制剂后的慢性胃炎及消化性溃疡患者，以不同方法检测幽门螺旋杆菌（ Hp）感染情况，通过对比阳性率及敏感性，发现短期应用质子泵抑制剂后 Hp 检测敏感方法。方法：以服用质子泵抑制剂但不超过1周（用药组）及未服用质子泵抑制剂（对照组）患者为入组条件，将两组各60例，分别取胃窦、胃体大弯侧黏膜，采用快速尿素酶法、病理组织切片染色检测，另行粪便 Hp 抗原检测，统计阳性率及敏感性，并进行两组间对比分析。结果：用药组60例患者中 Hp 阳性52例，阳性率86.7％，对照组60例患者中 Hp 阳性50例，阳性率为83.3％，两组间差异无统计学意义（P >0.05）。用药组胃体部尿素酶试验阳性率大于胃窦部（P <0.05），两组间胃窦部尿素酶试验阳性率低于对照组（P <0.01），胃窦、胃体病理组织学检测阳性率与对照组间差异无统计学意义（P >0.05）。而用药组中联合检测（胃窦+胃体）病理切片染色、胃窦病理+粪便 Hp 抗原、（胃体病理+粪便 Hp 抗原）阳性率均为80％，敏感性92.3％，阴性预测值较高，与胃窦病理、胃体病理、粪便 Hp 抗原检测相比差异无统计学意义（P >0.05），与尿素酶试验相比差异有统计学意义（P <0.01）。结论：短期应用质子泵抑制剂后对 Hp 尿素酶试验检测有明显影响，进行胃窦、胃体黏膜病理切片染色、粪便抗原检测或两者联合检测可以提高检测阳性率及敏感性。
目的：通過對短期應用質子泵抑製劑後的慢性胃炎及消化性潰瘍患者，以不同方法檢測幽門螺鏇桿菌（ Hp）感染情況，通過對比暘性率及敏感性，髮現短期應用質子泵抑製劑後 Hp 檢測敏感方法。方法：以服用質子泵抑製劑但不超過1週（用藥組）及未服用質子泵抑製劑（對照組）患者為入組條件，將兩組各60例，分彆取胃竇、胃體大彎側黏膜，採用快速尿素酶法、病理組織切片染色檢測，另行糞便 Hp 抗原檢測，統計暘性率及敏感性，併進行兩組間對比分析。結果：用藥組60例患者中 Hp 暘性52例，暘性率86.7％，對照組60例患者中 Hp 暘性50例，暘性率為83.3％，兩組間差異無統計學意義（P >0.05）。用藥組胃體部尿素酶試驗暘性率大于胃竇部（P <0.05），兩組間胃竇部尿素酶試驗暘性率低于對照組（P <0.01），胃竇、胃體病理組織學檢測暘性率與對照組間差異無統計學意義（P >0.05）。而用藥組中聯閤檢測（胃竇+胃體）病理切片染色、胃竇病理+糞便 Hp 抗原、（胃體病理+糞便 Hp 抗原）暘性率均為80％，敏感性92.3％，陰性預測值較高，與胃竇病理、胃體病理、糞便 Hp 抗原檢測相比差異無統計學意義（P >0.05），與尿素酶試驗相比差異有統計學意義（P <0.01）。結論：短期應用質子泵抑製劑後對 Hp 尿素酶試驗檢測有明顯影響，進行胃竇、胃體黏膜病理切片染色、糞便抗原檢測或兩者聯閤檢測可以提高檢測暘性率及敏感性。
목적：통과대단기응용질자빙억제제후적만성위염급소화성궤양환자，이불동방법검측유문라선간균（ Hp）감염정황，통과대비양성솔급민감성，발현단기응용질자빙억제제후 Hp 검측민감방법。방법：이복용질자빙억제제단불초과1주（용약조）급미복용질자빙억제제（대조조）환자위입조조건，장량조각60례，분별취위두、위체대만측점막，채용쾌속뇨소매법、병리조직절편염색검측，령행분편 Hp 항원검측，통계양성솔급민감성，병진행량조간대비분석。결과：용약조60례환자중 Hp 양성52례，양성솔86.7％，대조조60례환자중 Hp 양성50례，양성솔위83.3％，량조간차이무통계학의의（P >0.05）。용약조위체부뇨소매시험양성솔대우위두부（P <0.05），량조간위두부뇨소매시험양성솔저우대조조（P <0.01），위두、위체병리조직학검측양성솔여대조조간차이무통계학의의（P >0.05）。이용약조중연합검측（위두+위체）병리절편염색、위두병리+분편 Hp 항원、（위체병리+분편 Hp 항원）양성솔균위80％，민감성92.3％，음성예측치교고，여위두병리、위체병리、분편 Hp 항원검측상비차이무통계학의의（P >0.05），여뇨소매시험상비차이유통계학의의（P <0.01）。결론：단기응용질자빙억제제후대 Hp 뇨소매시험검측유명현영향，진행위두、위체점막병리절편염색、분편항원검측혹량자연합검측가이제고검측양성솔급민감성。
Objective The purpose of the study was to find a more sensitive method to detect Helicobacter pylori infection in patients taking proton pump inhibitors for a short period. Method 120 patients,who had either been on no medication or were already taking proton pump inhibitors for less than a week,were divided into two groups with 60 in each group. Biopsies taken from the gastric antrum and greater curvature of the stomach(body)were used for rapid urease testing and for histological examination. Stool samples were also tested for H. pylori stool antigen as an alternative indicator of infection. Results H. pylori organisms were detected in 52 of 60 patients taking proton pump inhibitors(86. 7% )and in 50 of 60 controls(83. 3% ). The positive rate of the antral urease test was significantly lower in patients taking proton pump inhibitors than in controls(P < 0. 01). Body urease test gave more H. pylori - positive results than that of antrum(P <0. 05). There was no significant difference between two groups in histology(P > 0. 05). Joint detection(sinus + body)pathology(antral pathology + stool antigen),(gastric pathology + stool antigen)showed positive rate of 80 % and sensitivity rate of 92. 3%. Negative pre-dictive value was higher,there was no significant rate difference compared between group. No significant difference when compared with an-trum pathology,gastric pathology,and HpSA stool(P > 0. 05);however,compared with gastric antrum and urease test,the result showed a significant difference( P < 0. 01). Conclusion Short - term Usage of proton pump inhibitors on the detection of Helicobacter pylo-ri. Conducting gastric biopsy,stained stool antigen test,or both combined detection can increase the level of detection.
