- 期刊
Simplified l3C-UREA Breath Test for the Diagnosis of Helicobacter Pylori Infection -the Availability of without Fasting and without Test Meal
簡化之碳-13尿素呼氣法用以診斷幽門螺旋桿菌感染－不空腹及不需試驗餐之可行性
摘要
傳統的碳-13尿素呼氣法用以檢查幽門螺旋桿菌威染，在施行時需要空腹及喝試驗餐以延長胃排空，本研究乃評估不需空腹及試驗餐是否可行。共計連續105個病人接受內視鏡檢查，並以尿素脢試驗，細菌培養及組織病理檢查來確定幽門螺旋桿菌的存在。每一個病人教接受四種不同狀況的實驗方式，包括實驗I：空腹及喝100cc鮮奶之試驗餐。實驗Ⅱ：不空腹（一般飲食）及喝試驗餐。實驗Ⅲ：空腹但沒有喝試驗餐。實驗Ⅳ：不空腹也不喝試驗餐，每個實驗在喝下碳-13尿素之後15分鐘收集呼氣樣本以計算其過剩之碳-13比值。結果有61個幽門螺旋桿菌陽性及44個陰性例，根據ROC曲線以3.0，4.0，3.5及4.0分別為四種實驗之界限值，結果實驗Ⅰ之靈敏度偶及特異性各為100%及95%，其他三種之靈敏度各為98%，98%及100%，特異性各為95%，98%及95%。我們的結論認為當界限值訂為4.0per mil時碳-13尿素呼氣法可以省略空腹及喝試驗餐的程序，這種簡化程序的碳-13尿素呼氣法（不必空腹、不喝試驗餐，再喝下碳-13尿素後15分鐘收集樣本）用在臨床診斷幽門螺旋桿菌感染是一種簡單可行的方法。
關鍵字
無資料並列摘要
The conventional 13C-urea breath test (13C-UBT) for detecting Helicobacter pylori infection was performed during fasting state and with a test meal to delay gastric emptying during the test. For the convenience of propagating this test, we assessed the availability of non-fast and without test meal in 13C-UBT for the diagnosis of H. pylori infection. One hundred and five consecutive patients who received endoscopic examination were studied. All of them received endoscopic biopsy for urease test, culture and histopathology to determine whether there was a presence of H. pylori infection. Each patient received four separate 13C-UBT under the following four testing conditions. Test I )fasting state with test meal ( 100ml fresh milk ), Test II ) non-fast ( taking usual food) but with test meal, Test III ) fasting state without test meal, and Test IV ) non-fast and without test meal. The excess 13CO2 values were calculated via the breathed samples that were collected at 15 minutes after ingestion of 13C-urea. There were 61 H. pylori positive and 44 negative patients in this study, with an excess 13CO2 values 3.0, 4.0, 3.5 and 4.0 as a cut-off value in the four tests respectively, according to the ROC curve. The results of test I, a conventional procedure, had a good correlation with the gold standard. The sensitivity and specificity were 100% and 95% respectively. The alternative procedures in other tests also have high sensitivity and specificity at IS-minute detecting time. The sensitivity of the tests II、III and IV at IS-minute detecting times were 98%,98% and 1000/0, and the specificities of those were 95%, 98%and 95% respectively. We therefore suggest that fasting and test meal possibly be omitted when the cut-off value is 4.0 per mil in the simplified 13C-UBT (non-fast and without test meal, and detection at 15 minutes after ingestion of 13C-urea) which is a simple and available procedure for clinical diagnosis of H. pylori infection.