【摘要】 目的：探讨¹³C-尿素呼气试验(¹³C-UBT)诊断幽门螺杆菌（Hp）准确率的影响因素。方法：回顾性分析2019年2月-2021年9月在福建省立金山医院行麻醉胃镜检查且无Hp治疗史患者200例。所有患者均进行麻醉胃镜检查及¹³C-UBT检查。按照金标准将其分为Hp+组和Hp-组，收集两组一般资料。对¹³C-UBT诊断Hp准确性进行单因素分析及多因素分析。结果：按照金标准将其分为Hp+组（113例）和Hp-组（87例）。胃镜检查前行¹³C-UBT诊断Hp的准确率高于胃镜检查后（χ²=10.731，P=0.001）。颗粒型尿素试剂¹³C-UBT诊断Hp的准确率高于胶囊型尿素试剂（χ²=11.908，P=0.001）。黏膜重度萎缩¹³C-UBT诊断Hp的准确率低于非重度萎缩黏膜（χ²=19.915，P=0.000）。Logistic分析，胃镜操作后、胶囊型尿素试剂及重度萎缩黏膜是¹³C-UBT诊断Hp准确率下降的危险因素（P<0.05）。结论：胃镜操作、呼气试验试剂类型及黏膜萎缩状态是¹³C-UBT诊断幽门螺杆菌准确率的影响因素。在胃镜检查前或选择颗粒型尿素试剂可提高¹³C-UBT诊断Hp的准确性。重度萎缩性胃黏膜需联合多种检测方法以提高Hp诊断的准确性。更多还原

【Abstract】 Objective:To explore the influencing factors of the accuracy of ¹³C-urea breath test (¹³C-UBT) in the diagnosis of Helicobacter pylori （Hp）.Method:A retrospective analysis was performed on 200 patients who underwent anesthesia gastroscopy examination in Fujian Provincial Jinshan Hospital from February 2019 to September 2021 and had no treatment history of Hp.All patients underwent anesthesia gastroscopy and ¹³C-UBT examination.According to the gold standard,they were divided into Hp+ group and Hp-group,and general data of the two groups were collected.The accuracy of ¹³C-UBT in the diagnosis of Hp was analyzed by univariate analysis and multivariate analysis.Result:They were divided into Hp+ group （113 cases） and Hp-group （87 cases） according to the gold standard.The accuracy of ¹³C-UBT in diagnosing Hp before gastroscopy examination was higher than that after gastroscopy examination （χ²=10.731,P=0.001）.The accuracy of granular urea reagent ¹³C-UBT in diagnosing Hp was higher than that of capsule urea reagent （χ²=11.908,P=0.001）.The accuracy of ¹³C-UBT in the diagnosis of Hp in severely atrophic mucosa was lower than that in non severely atrophic mucosa （χ²=19.915,P=0.000）.Logistic analysis showed that after gastroscopy operation,capsule urea reagent and severely atrophic mucosa were the risk factors for the decline of the accuracy of ¹³C-UBT in the diagnosis of Hp （P<0.05）.Conclusion:Gastroscopy operation,breath test reagent type and mucosal atrophy state are the risk factors for the accuracy of diagnosis of Hp by ¹³C-UBT.The accuracy of ¹³C-UBT in the diagnosis of Hp can be improved by choosing before gastroscopy examination and granular urea reagent.In order to improve the diagnostic accuracy of Hp,multiple detection methods should be combined for severe atrophic gastric mucosa.更多还原