血清转化在确认治愈Helicobacter pylori感染中的作用
1Department of Internal Medicine, University of Texas Health Science Center at Dallas, USA. feldman.mark@dallas.va.gov
JAMA
|August 1, 1998
概括
血清检测可以确认Helicobacter pylori治疗后一年以上的治愈. 无法检测到的抗体水平准确地表明了健康个体的成功根除.
科学领域:
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
- 临床诊断 临床诊断 临床诊断
背景情况:
- 血清学测试在确认Helicobacter pylori (H. pylori) 感染治愈后抗菌疗法的确切作用尚不清楚.
- 准确确认H pylori根除对于患者管理和预防并发症至关重要.
研究的目的:
- 评估血清学测试在完成抗菌药物治疗后一年以上确认治愈H pylori感染的有效性.
- 评估抗体水平变化的有用性,以区分治愈和未治愈的患者.
主要方法:
- 在一个学术退伍军人事务医疗中心进行了前性,前后干预研究.
- 二十三名H pylori阳性个体接受了为期14天的比斯木斯,四环素和甲氧化疗程.
- 对H pylori的IgG血清抗体在基线和治疗后1,3个月和大约18个月内被测量,与胃活检结果作为黄金标准进行比较.
主要成果:
- 在23名参与者中,15人 (65%) 获得了通过活检确认的H pylori治愈. 他们的抗体水平中位数从92.5U/mL下降到18个月后无法检测到的水平.
- 8名参与者 (35%) 没有治愈,患有持续性胃炎. 18个月后,他们的抗体水平中位数从130.6 U/mL下降到89.7 U/mL.
- 血清转换表明,在检测H.pylori治疗时,其灵敏度为60%,特异性为100%.
结论:
- 治疗后一年以上无法检测到的H pylori抗体水平可靠地证实了最初阳性,健康个体的感染治愈.
- 血清检测,特别是缺少抗体,提供了一种有价值的非侵入性方法,以合理的灵敏度来确认H pylori的根除.
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