摘要
目的探讨胃窦黏膜活检快速尿素酶试验(RUT)和病理学法检测幽门螺杆菌(Helicobacter pylori,H.pylori)的阳性率及其在艾滋病(AIDS)、慢性肝病和普通慢性胃病患者中的差异。方法选取937例因上腹部不适接受胃镜检查的患者,其中艾滋病组患者61例(艾滋病组),慢性肝病组患者600例(慢性肝病组),非艾滋病非肝病普通慢性胃病组患者276例(普通慢性胃病组)。所有患者均于胃镜检查中胃窦部取活检组织2块,分别进行RUT和病理学检测法检测H.pylori。结果胃窦黏膜活检RUT H.pylori的总体阳性率为47.0%,病理学染色检测法的总体阳性率为35.3%;艾滋病组和普通慢性胃病组病理学检测H.pylori阳性率(45.9%、57.97%)均高于同组RUT检验H.pylori阳性率(37.7%、38.77%,P<0.05);慢性肝病组RUT检测H.pylori阳性率(42.83%)高于病理学检测H.pylori阳性率(32.67%)(P<0.05);以病理学检测结果为最终诊断,慢性肝病组患者H.pylori感染率小于艾滋病组和普通慢性胃病组(P<0.05),艾滋病组患者H.pylori感染率小于普通慢性胃病组,但差异无统计学意义(P>0.05)。结论艾滋病、慢性肝病和普通慢性胃病患者胃窦黏膜活检RUT与病理学法检测H.pylori均有显著性差异,临床最终诊断结果仍应以病理学检测结果为准;慢性肝病患者RUT检测H.pylori存在较高假阳性及其H.pylori感染率低于艾滋病患者和普通慢性胃病患者。
Objective To investigate the positive rate of Helicobacter pylori （H.pylori） by gastric antrum mucosal biopsy rapid urease test （RUT） and pathologic staining,and the differences in AIDS patients,chronic liver disease patients and common gastric disease patients.Methods Nine hundred and thirty-seven patients who accepted endoscopy due to upper abdominal discomfort were selected,including 61 cases of AIDS （AIDS group）,600 cases of chronic liver disease （chronic liver disease group）,276 cases of common gastric disease who were non-AIDS and non-liver disease （common gastric disease group）.Two pieces of antrum mucosa were taken from the gastroscopy in all the patients,and made PUT,HE staining,respectively.Results The total positive rate of H.pylori was 47％ by RUT.The total positive rate of pathologic staining was 35.3 ％.The positive rates of AIDS group and common gastric disease group by pathological detection （45.9％ vs 57.97％） were higher than those of the same group by RUT （37.7％ vs 38.77％,P ＜0.05）.The positive rate of the chronic liver disease group by RUT （42.83％） was higher than pathologic staining （32.67％）（P ＜ 0.05）.According to the pathological results as the final diagnosis,the H.pylori infection rate of chronic liver disease group was less than the AIDS group and common gastric disease group （P ＜ 0.05）,the infection rate of H.pylori in AIDS patients was lower than that of common gastric disease group,but there was no significant difference （P ＞ 0.05）.Conclusion There were significant differences in AIDS,chronic liver disease and common gastric disease by mucosa biopsy with RUT and pathology staining method for detection of H.pylori.The final prevail diagnosis should still be the pathology staining results in clinical.Fale positive rate of H.pylori by RUT is high in chronic liver disease and the infection rate of H.pylori is lower than the common gastric disease patients and AIDS patients.
出处
《胃肠病学和肝病学杂志》
CAS
2014年第9期1004-1007,共4页
Chinese Journal of Gastroenterology and Hepatology
