与某些炎症因子相关的幽门螺杆菌诊断方法准确性的比较研究

E. N. Naji
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引用次数: 3

摘要

本研究的目的是诊断幽门螺旋杆菌是引起胃十二指肠刺激和溃疡的主要病原体。采用不同的技术进行有创试验(组织病理学检查、快速尿素CLO试验和培养),而无创试验包括(血清学试验和粪便抗原)以及患者血清中某些免疫反应因子(IgM、IgG、IgA)以及(IL - 8和IFN - y)的测定。有创诊断结果为30/113例(26.69%)感染,83/113例(73.31%)未感染;无创诊断结果为25/113例(22.14%)感染,88/133例(77.83%)未感染。为了得到纳入本研究的感染人群的总体百分比,我们将两种方法的结果合并,发现有创和无创方法诊断的幽门螺杆菌感染患者总数为42 /113(37.2%),非有创方法诊断的幽门螺杆菌感染患者总数为71/113(62.8),男性为27/68(39.71%),高于女性感染者的15/45(33.33%)。幽门螺杆菌感染在46-60岁年龄组的男性和女性中高发。组织学(有创teq)和ECO快速检测(无创teq)被认为是幽门螺杆菌检测的“最佳技术”,因为它具有高特异性、敏感性,并且与本工作中使用的其他技术一起检测了大部分幽门螺杆菌阳性患者。组织学检测的敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV)分别为100,100,100和94.5%,而ECO快速检测的敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV)分别为96,93,91.5%和97.14%。培养(有创teq)和抗幽门螺杆菌IgG(无创teq)在幽门螺杆菌感染的诊断中排名第二,因为它们比前两种teq检测到的感染患者数量少一些。如上所述。Culture检测的灵敏度、特异度、PPV (NPV)分别为80%、97%、96.96%和87.5%,IgG抗幽门螺杆菌检测的灵敏度、特异度和NPV分别为85%、91%、92.8%和97.8%。最后从其余6个teq中得到最小的患者数。本工作采用尿素CLO试验和粪便抗原、有创和无创teq。分别。本研究发现,快速抗幽门螺杆菌ECO试验结果与ELFA抗体滴度、免疫球蛋白(IgG、IgA)和(IFN-γ)、(IL-8)浓度之间存在一定的关系。此外,这些数据与患者与未感染成员相比的组织学变化和尿素CLO测试结果有关。这些结果显示,与未感染组相比,患者组之间的差异非常显著(p值< 0.001)。另一方面,IgM浓度与任何其他诊断方法的结果之间没有关系,这些结果被认为是确定感染易感性的第一步,并通过每次多使用一次测试来确认诊断,特别是组织学(侵入性teq)和ECO快速测试(非侵入性teq)与估计(IgG和IgA)和(IFN-γ), (IL-8)浓度相关
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Comparative Study for the Accuracy of Helicobacter pylori Diagnostic Methods Associated with Some Inflammatory Factors
This Study was intended to diagnose H. pyiori the major causative pathogen in gastro duodenal irritation and ulceration. Differert techniques were used invasive tests (histopathological examina-tion, rapid urea CLO test and culture) , while noninvasive tests includes (serological tests and stool antigen) in addition to determination of some immune response factors (IgM , IgG , IgA) as well as (IL – 8 and IFN – y) in Ptients Sera. According to the results of invasive diagnostic method 30/113 (26.69%) patients were considered to be infected and 83/113(73.31%) patients were considered as noninfeted was contrasted with noninvasive diagnostic method 25/113 (22.14%) patients were considered to be infected and 88/133(77.83%) patients were considered as noninfeted. In order to get the overall percentage of the infected people included in this study, we merge the results of the two methods ,so we found out that the total infected patients with H. pylori diagnosed by invasive and noninvasive methods were 42 /113 (37.2%) while the noninfected 71/113 (62.8) disseminated as 27/68(39.71%) infect-ed male ,which was privileged than the infected female when it was 15/45(33.33%). The high prevalence of H. pylori infection in the age group ranging between (46-60) in male and female. Histology (invasive teq.) and ECO rapid test (noninvasive teq.) were considered as the ‘‘best techniques ’’ for H. pylori detection, in the outlook of its high specificity, sensitivity and because it detected the major number of H. pylori-positive patients along with the other techniques used in this work. The sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) for histology were 100,100,100 and 94.5% , respectively, while for the ECO rapid test they were 96, 93, 91.5, and 97.14%. Culture (invasive teq.) and IgG anti H. pylori (noninvasive teq.) coming secondly in the diagnosis of H. pylori infection because they detected a little fewer number of infected patients than the first two teq. as noted above. The sensitivity, specificity, (PPV) (NPV) for Culture were 80%, 97% ,96.96% and87.5% and for IgG anti H. pylori were 85%, 91%,92.8% and 97.8%. Finally the smallest patient number was obtained from the rest of all the six teq. were used in the present work obtained from the urea CLO test and stool antigen, in-vasive and noninvasive teq. respectively. The present research found out that there were a relationship between the results of rapid anti H. pylori ECO test, antibody titer in ELFA, immunoglobulin (IgG and IgA) and (IFN-γ) , (IL-8) concentration. Also, all these data were related to the results of the histological changes and the results of the urea CLO test of patients when compared with the noninfected members. These results showed highly significant differences among patient groups in comparison with noninfect-ed group at (P. Value < 0.001). On the other hand, there were no relationship between IgM con-centration with any of the other results of diagnostic methods were used may such results consid-ered a first step for determining the susceptibility of infection and to confirame the diagnosis by use one more test in each time especialy Histology (invasive teq.) and ECO rapid test (noninva-sive teq.) correlated with estimation of (IgG and IgA) and (IFN-γ), (IL-8) concentration
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