【摘要】 目的 评价快速尿素酶试验(RUT)在根除治疗前后诊断幽门螺杆菌(Hp)感染的准确性。方法选择250例接受胃镜检查的患者,123例无Hp根除治疗史,127例为Hp根除治疗后复查患者。每例患者取胃窦和胃体活检标本各3块,分别用于RUT、细菌培养和病理组织学检查。以细菌培养及病理组织学检查结果作为“金标准”,即培养和(或)组织学检查结果阳性者为Hp阳性,而培养和组织学检查结果同时阴性者为Hp阴性或Hp根除。结果 未行Hp根除治疗的患者RUT正确的诊断了86例Hp阳性中的84例和37例Hp阴性中的34例,其敏感性和特异性分别为97.7％和91.9％。根除治疗后RUT敏感性和特异性分别为64.3％和99.0％。然而,根除治疗后6个月以上复查胃镜,RUT敏感性和特异性均达100％。结论 根除治疗前和根除治疗后6个月以上复查,RUT诊断Hp感染准确性高。更多还原

【Abstract】 Objective To evaluate the accuracy of RUT for the diagnosis of H. pylori infection before and after eradication therapy using bacterial culture and histological examination as gold standard. Methods A total of 250 patients undergoing gastroendoscopy, including 127 and 123 patients with or without previous H. pylori eradication therapy respectively were randomly selected. Each of the biopsy specimens was taken from the antrum and body of stomach for RUT, culture, and histological examination. The data of positive culture and/or positive histology were defined as H. pylori infection. It was judged H. pylori negative or eradication of the bacteria only when the results of culture and histological examination were both negative. Results In cases before eradication therapy, RUT correctly diagnosed in 84 of 86 H. Pylori-positive cases, and 34 of 37 H. Pylori-negative cases. The overall accuracy was 95.9%. The sensitivity and specificity of RUT before eradication were 97. 7% and 91. 9% respectively. In cases after eradication therapy, RUT gave correct diagnoses in 18 of 28 H. pylori - positive cases and in 98 of 99 H. pylori-negative cases with sensitivity 64. 3% and specificity 99. 0% . However, when RUT was used more than 6 months after the end of eradication therapy, both the sensitivity and specificity increased to 100%. Conclusions RUT is highly accurate for the diagnosis of H. pylori infection in untreated and treated patients who were examined more than 6 months after the completion of therapy.更多还原