- 期刊
Diagnosis of Helicobacter Pylori Infection by Stool Antigen Test in Southern Taiwan
糞便中幽門螺旋桿菌抗原的檢測－南台灣的研究
摘要
幽門螺旋桿菌（簡稱H. pylori）已被發現和許多胃腸道的疾病相關。而H. pylori感染的確認包括了侵襲性和非侵襲性的方法，有愈來愈多的人對以非侵襲性方法檢測H. pylori有興趣。本篇研究的目的在評估和比較糞便H. pylori抗原檢驗的可信度和正確性。本研究共收集32位病人（男18人，女14人，年齡：23-91歲，平均年齡：50.5歲）在高雄醫學大學附設醫院接受胃鏡檢查並且H. pylori檢測者進入本研究，H. pylori感染的確認是以細菌培養或是三個檢查中包括CLO test、組織學檢查、13C尿素呼氣試驗有二個為陽性者為H. pylori陽性。而先前經胃腸道手術，一個月內使用抗生素、proton pump inhibitor或含Bismuth藥者，及之前曾經H. pylori根除治療者則排除在外。其中有１４位病生有十二指腸潰瘍，4位有胃潰瘍，12位有胃炎，2位有胃潰瘍和十二指腸潰瘍。而同時收集病人糞便以酵素免疫分法（HpSA）檢測糞便中H. pylori抗原。在18位幽門螺旋桿菌陽性病人中有16位以HpSA檢測為陽性，而在幽門螺旋桿菌陰性病人中有13位以HpSA檢測為陰性。HpSA的敏感性為88.9%，特異性為92.9%，陽性預測值為94.1%，陰性預測值為86.7%。而目測法和光譜儀判定之一致性達100%。我們的結論是酵素免疫分析法（HpSA）測糞便中幽門螺旋桿菌抗原是一種非侵襲性、準確的、可信賴的且簡單又快速的方法來診斷幽門螺旋桿菌，不管是用目測法或是光譜儀。
關鍵字
無資料並列摘要
Helicobacter pylori (H. pylori) has been found to be associated with various gastrointestinal diseases. Confirmation of H. pylori infection includes invasive and non-invasive methods. There has been increasing interest in noninvasive tests recently. However, the geographical differences among H. pylori strains have been emphasized recently and the H. pylori strain in Taiwan showed a high cagA positive result and different vacA subtype when compared with those of Western countries. The aim of this study is to access and compare the reliability and the diagnostic accuracy of the stool If. pylori antigen tests by spectrophotometry and by the visual method, especially in Southern Taiwan. Thirty-two patients (18 men and 14 women; age range: 23-91 y/o, mean: 50.5 y/o) who underwent gastroendoscopy at Kaohsiung Medical University Hospital were enrolled in this study. H. pylori infection status was confirmed by culture or two positive test results on CLO test, histology and 13C-urea breath test (13C-UBT) . The exclusion criteria included previous gastrointestinal tract surgery, use of antibiotics, proton pump inhibitor or compounds containing bismuth within 1 month。of the study. Among them, 14 patients were with duodenal ulcer (DU), 4 with gastric ulcer (GD), 12 with non-ulcer dyspepsia, and 2 with GU and DU. Those patients had their stool collected for ELISA tests of H. pylori stool antigen (HpSA). The HpSA tests were positive in 16 of 18 patients diagnosed as H. pylori positive, and negative in 13 of 14 patients as H. pylori negative. The sensitivity and specificity were 88.9% and 92.9% respectively. The positive and negative predictive values were 94.1 % and 86.7% respectively. The concordance of HpSA accessed by spectrophotometry and visual method is 100%, which makes . this test even easier and cheaper. We concluded that stool HpSA test is a noninvasive, accurate, reliable, rapid and easy way to diagnose H. pylori infection in Southern-Taiwan, either by spectrophotometry or by visual assessment.