ヘリコバクター・パイロリ感染症の治癒を確認する際に血清転換の役割
1Department of Internal Medicine, University of Texas Health Science Center at Dallas, USA. feldman.mark@dallas.va.gov
JAMA
|August 1, 1998
まとめ
血清検査は,治療後1年以上でヘリコバクター・パイロリ菌の治癒を確認することができます. 検出不能の抗体レベルは,健康な個体における成功した根絶を正確に示す.
科学分野:
- 胃腸内科 胃腸内科
- 感染症 感染症は感染症です.
- クリニカル診断士
背景:
- ヘリコバクター・パイロリ (H. pylori) 感染症の治癒と抗菌剤の治療後の治癒を確認するための血清検査の決定的な役割は不明である.
- H pyloriの根絶の正確な確認は,患者の管理と合併症の予防に不可欠です.
研究 の 目的:
- 抗菌薬療法を終了してから1年以上経過したH・ピロリ感染の治癒を確認するための血清検査の有効性を評価する.
- 治癒した患者と治らない患者の区別における抗体レベルの変化の有用性を評価する.
主な方法:
- アカデミックな退役軍人の医療センターで,前後の介入研究が行われました.
- 23人のH・ピロリ陽性患者は,ビスムート,テトラサイクリン,メトロニダゾールを14日間投与した.
- H pyloriに対するIgG血清抗体は,治療開始時および1,3,および治療後約18ヶ月で測定され,黄金基準として胃バイオプシの結果と比較されました.
主要な成果:
- 23人の参加者のうち,15人 (65%) がバイオプシーで確認されたH・パイロリ治癒を達成しました. 彼らの抗体の平均値は92.5U/mLから18ヶ月で検出不能レベルまで減少しました.
- 8人の参加者 (35%) は治癒できず,胃炎が持続した. 彼らの抗体の平均濃度は18ヶ月で130.6U/mLから89.7U/mLに低下した.
- 血清変換は,H. pyloriの治療を検出する際に60%の感度と100%の特異性を示しました.
結論:
- 治療後1年以上にわたって検知できないH・パイロリ抗体のレベルは,当初陽性で健康な個体において,感染の治癒を確実に確認します.
- 血清検査,特に抗体の欠如は,H pyloriの根絶を合理的な感度で確認するための貴重な非侵襲的方法を提供します.
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