[Objective] Our aim was to investigate the value of stool Helicobacter pylori antigen test (HpSA)in the diagnosis of Hp in patients with gastrointestinal diseases. [Methods] The totals of 142 patients who came to our hospital due to gastrointestinal symptoms were selected as the subjects from April 2015 to May 2016. Everyone accepted the rapid urease test(RUT), HpSA and Hp-PCR detection. The results of RUT detection were used as the criteria for the diagnosis of Hp infection. We analyzed the clinical value of HpSA and PCR. [Results]The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and accuracy of HpSA detection were 77.03％ (57/74), 97.06％ (66/68), 25.67, 0.24 and 86.62％ (123/142), respectively. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and accuracy of PCR detection were 72.97％(54/74), 94.12％(64/68), 12.17, 0.29 and 83.10％(118/142), respectively. The consistency between HpSA and RUT was good, Kappa=0.73. The receiver operating characteristic curve (ROC) were drawn according to the test results. The area under the curve (AUC) of HpSA was 0.870 + 0.032, and the AUC of PCR was 0.835 + 0.036. [Conclusion]HpSA has high sensitivity, specificity and accuracy in diagnosis of Hp infection. It is non-invasive, painless, and suitable for patients who are unwilling or unable to perform RUT detection. It is suitable for patients with gastrointestinal diseases, which is an ideal alternative to invasive tests.%[目的]探讨粪便幽门螺杆菌抗原检测(Helicobacter pylori stool antigen test, HpSA)在胃肠疾病患者中诊断幽门螺杆菌(Helicobacter pylori, Hp)感染的价值.[方法]选择因消化道症状就诊的142例患者作为研究对象,进行快速尿素酶试验(rapid urease test, RUT)、HpSA及胃黏膜Hp-PCR检测,以RUT结果作为诊断Hp感染的判断标准,分析HpSA及PCR检测的临床实用价值.[结果]HpSA检测的灵敏度、特异度、阳性似然比、阴性似然比及准确度分别为77.03％(57/74)、97.06％(66/68)、25.67、0.24及86.62％(123/142),PCR检测的灵敏度、特异度、阳性似然比、阴性似然比及准确度分别为72.97％(54/74)、94.12％(64/68)、12.17、0.29及83.10％(118/142),HpSA与RUT-致性好,Kappa=0.73.将检测结果绘制受试者工作特征曲线(receiver operating characteristic curve, ROC),HpSA的曲线下面积(area under the curve, AUC)为0.870 ± 0.032,PCR的 AUC为0.835 ±0.036.[结论]HpSA诊断Hp感染灵敏度、特异度及准确度高,无创、无痛苦,适用于不愿或不能行RUT检测的患者,是侵入性检查的理想替代方法.
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