幽门螺杆菌粪便抗原检测

幽门螺杆菌粪便抗原检测,幽门螺杆菌或幽门螺旋杆菌、幽门螺旋菌（学名：Helicobacterpylori）是革兰氏阴性、微需氧的细菌，生存于胃部及十二指肠的各区域内。它会引起胃黏膜轻微的慢性发炎，甚或导致胃及十二指肠溃疡与胃癌。超过80%的带原者并不会表露病征。世界超过50%人口在消化系统上部带原有幽门螺杆菌。感染较盛行于发展中国家，而西方国家的影响范围也逐渐缩小。幽门螺杆菌的传染途径不明，但个体通常是于幼时被感染。美国国立卫生研究院（NIH）提出大多数常见的胃炎疾病均由幽门螺杆菌所造成，在治疗过程应加入抗生素。在正确认识该细菌以前，胃溃疡病人通常会以中和胃酸及减少分泌的药物来治疗，但经此方法治疗后大多会复发。而胃炎患者则会服用碱式柳酸铋，这方法通常会见效，当时人们仍不知道其机制，后来才发现药物中的柳酸盐会杀死胃部的杆菌，可作为抗生素。现时，这类疾病会以抗生素来杀灭病菌。幽门螺杆菌是人类至今唯一一种已知的胃部细菌。HP感染是世界上最常见的人类细菌感染之一，被认为是慢性胃炎、消化性溃疡的主要原因，世界卫生组织(WHO)将HP列为第1类致病因子。长期的溃疡，会导致癌症，因此WHO宣布胃幽门杆菌为微生物型的致癌物质，也是第一个被确认可对人类致癌的原核生物。,幽门螺杆菌简介,第四次全国幽门螺杆菌感染处理共识报告,对于无示警症状者的testandtreat策略,TestsforHelicobacterpyloriinfection,常用检测Hp方法对比总结,Title:Evaluationofenzyme-linkedimmunosorbentassayforthediagnosisofHelicobacterpyloriinfectioninchildrenfromdifferentagegroupswithandwithoutduodenalulcer.Author:deOliveira,A.M.;Rocha,G.A.;Queiroz,D.M.(.)Source:JPediatrGastroenterolNutr,1999,28(2):157-161Abstract:BACKGROUND:.METHODS:Asecond-generationELISAwasusedtoevaluatetheIgGresponsetoH.pyloriintheserumof130consecutivechildrenwhounderwentuppergastrointestinalendoscopy.ThepresenceofH.pyloriwasdeterminedinantralbiopsyspecimensbyculture,ureasetest,andhistologicanalysis.RESULTS:Sixty-eightchildren(allofthe20whohadduodenalulcer)wereH.pyloripositivebymicrobiologictest.ImmunoglobulinGantibodiestoH.pyloriweredetectedin79.4%oftheinfectedchildrenandin8.1%ofthenoninfectedones.Thesensitivityofthetestwashigherinpatientswithduodenalulcer(100%)thaninthosewithout(70.8%).Whenusedinchildrenofdifferentagesthetestalsopresenteddifferencesinsensitivity:44.4%inchildren2to6yearsold;76.7%inchildren7to11yearsold,and93.1%inchildren12to16yearsold(p=0.006).TheserumimmunoglobulinGconcentrationwassignificantlyhigher(p=0.0003)inchildrenwithduodenalulcerthaninthosewithoutandwashigherinolderchildrenthaninyoungeroneswithoutduodenalulcer(p=0.05).CONCLUSIONS:Theaccuracyofthetestinchildrenwithduodenalulcerandinchildrenmorethan12yearsoldwasgood;however,inchildrenupto12yearsofagewithoutduodenalulcer,thesensitivityofthetestwastoolowtobeusedforscreeningpurposesortoruleoutthepresenceofinfection.,幽门螺杆菌血清学检测在儿童和青少年的灵敏度分析,1.Non-invasiveserologicaltestshavebeenwidelyusedforthediagnosisofH.pyloriinfection.Inadults,thismethodhasprovedtobehighlyaccuratetodiagnosetheinfection,butinchildren,especiallyyoungerones,ELISAappearedtoshowlowsensitivityforthediagnosisofH.pyloriinfectioninchildrenaged2to12years,especiallyinthosewithoutduodenalulcer.2.幽门螺杆菌清除术后，血液中抗体仍长期存在，起不到监测评估疗效的作用。适合流行病学调查。3.多省暂无收费标准,幽门螺杆菌血清学检测评价,RESULTS:Twenty-twostudies,including2,499patients,evaluatedthemonoclonalSAT（stoolantigentest）beforeeradicationtherapy.Pooledsensitivity,specificity,LR+,andLRwere:0.94(95%CI0.930.95),0.97(0.960.98),24(1541),and0.07(0.040.12).TheaccuracyofbothmonoclonalandpolyclonalSATwasevaluatedtogetherin13pretreatmentstudies,andhigherpooledsensitivitywasdemonstratedwiththemonoclonaltechnique(0.95vs0.83).Twelvestudies,including957patients,assessedthemonoclonalSATtoconfirmeradicationaftertherapy.Pooledsensitivity,specificity,LR+,andLRwere0.93(0.890.96),0.96(0.940.97),17(1223),and0.1(0.070.15).Bothtestswereevaluatedtogetherineightpost-treatmentstudiesand,again,themonoclonaltechniqueshowedhighersensitivity(0.91vs0.76).Heterogeneityamongstudiesdisappearedwhenasingleoutlierstudywasexcluded.Subanalysisdependingonthereferencemethod,thestudypopulation,orthestudyqualityshowedsimilarresults.CONCLUSION:MonoclonalSATisanaccuratenoninvasivemethodbothfortheinitialdiagnosisofH.pyloriinfectionandfortheconfirmationofitseradicationaftertreatment.Themonoclonaltechniquehashighersensitivitythanthepolyclonalone,especiallyinthepost-treatmentsetting.AccuracyofmonoclonalstoolantigentestforthediagnosisofH.pyloriinfection:asystematicreviewandmeta-analysis(AmJGastroenterol2006;101:19211930),幽门螺杆菌粪便抗原检查(HpSA)和