杨晓扬1，李艳2，罗海波1，刘运周1，姚尚彦1，沙建平1
1.解放军第421医院，广东广州510318; 2.南方医科大学附属何贤纪念医院，广东广州511400

摘要：目的  通过对5种幽门螺杆菌检测方法的比较，为临床选择检测方法提供参考。方法  检查前留取粪便标本，检查时在胃窦和胃体钳取黏膜组织并抽血2ml，采用快速尿素酶试验法、胃黏膜组织染色法、血清抗体检测法、¹³C-尿素呼气试验（¹³C-UBT)和粪便抗原（HpSA)检测法对458例消化道疾病患者进行幽门螺杆菌检测，比较不同方法的敏感度、特异度、准确度以及与诊断标准的吻合度。结果  在5种检测方法中，病理切片染色的灵敏度最高，达0.983，血清抗体检测灵敏度最低，仅为0.899，总体差异有统计学意义（P<0.05)；¹³C-UBT特异度最高，达0.906，血清抗体检测特异度最低，只有0.801，总体差异有统计学意义（P<0.05)；¹³C-UBT准确度最高，为0.951，各方法总体差异有统计学意义（P<0.05)；5种方法的k值均>0.8。结论5种方式均为幽门螺杆菌的有效检测方法，其中¹³C-UBT具有较高的诊断价值，临床应用时需结合个体情况选择合适的检测方法。
关键词：幽门螺杆菌；检测；灵敏度；特异度
中图分类号：R446.5    文献标识码：A    文章编号：1004 -8685(2015) 11 -1758 -03

Comparison of 5 different detection methods for Helicobacter pylori
YANG Xiao - yang ,  LI Yan,  LUO Hai - bo, LIU Yun - zhou, YAO Shang - yan,  SHA Jian - ping
The 421 th Hospital of PLA,  Guangzhou,  Guangdong 510318, China

Abstract: Objective To provide reference for clinical detection method choosing by comparing to the detection methods of  Helicobacter pylori (Hp). Methods  Before the examination, to sample stool specimens; during inspection, from the mucosal tis¬sue of gastric antrum and body of stomach, to sample blood 2 ml with clamp. By rapid urease test, gastric mucosa staining, serum antibody detection method, ¹³C urea breath test (¹³C-UBT) and stool antigen (HPSA) detection method, 458 cases of gastrointestinal diseases were detected for  Helicobacter pylori, and to compare the sensitivity, specificity, accuracy and and the degree of agreement with diagnostic criteria in different methods. Results  The W - S section staining had the highest sensitivity (0.983), the ELISA technique had the lowest sensitivity (0. 899) . The difference was statistically significant (P <0. 05) . The 13 C - UBT had the highest specificity (0. 906), the ELISA technique had the lowest specificity (0. 801) . The difference was sta¬tistically significant (P <0. 05) . 13 C - UBT also had the highest accuracy (0.951), the difference was statistical significant (P <0. 05) . The Kappa value was more than 0.8 of all methods. Conclusion All the 5 methods are effective to Hp detection, among them ¹³C-UBT has the highest diagnostic value. Individual condition should be considered during clinical application.
Key Words:  Helicobacter pylori; Detection; Sensitivity; Specificity