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首页> 外文期刊>Journal of Clinical Microbiology >Real-Time PCR for Diagnosing Helicobacter pylori Infection in Patients with Upper Gastrointestinal Bleeding: Comparison with Other Classical Diagnostic Methods
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Real-Time PCR for Diagnosing Helicobacter pylori Infection in Patients with Upper Gastrointestinal Bleeding: Comparison with Other Classical Diagnostic Methods

机译：实时PCR诊断上消化道出血患者幽门螺杆菌感染：与其他经典诊断方法的比较

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摘要

The aim of this study was to determine the diagnostic usefulness of quantification of the H. pylori genome in detection of infection in patients with upper gastrointestinal bleeding (UGB). A total of 158 consecutive patients with digestive disorders, 80 of whom had clinical presentation of UGB, were studied. The number of microorganisms was quantified using a real-time PCR system which amplifies the urease gene with an internal control for eliminating the false negatives. A biopsy sample from the antrum and corpus of each patient was processed. The rapid urease test, culture, histological study, stool antigen test, and breath test were done. The gold standard was a positive culture or positive results in at least two of the other techniques. When a positive result was defined as any number of microorganisms/human cell, the sensitivity of real-time PCR was greater in bleeding patients, especially in the gastric corpus: 68.4% (95% confidence interval [CI], 52.3 to 84.5%) in non-UGB patients versus 91.5% (95% CI, 79.6 to 97.6%) in UGB patients. When a positive result was defined as a number of microorganisms/human cell above the optimal value that maximizes the Youden index (>3.56 microorganisms/human cell in the antrum and >2.69 in the corpus), the sensitivity and specificity in UGB patients were over 80% in both antrum and corpus. Our findings suggest that some bleeding patients with infection caused by H. pylori may not be correctly diagnosed by classical methods, and such patients could benefit from the improved diagnosis provided by real-time PCR. However, the clinical significance of a small number of microorganisms in patients with negative results in classical tests should be evaluated.
机译：这项研究的目的是确定幽门螺杆菌基因组定量检测对上消化道出血（UGB）患者感染的诊断价值。总共研究了158位连续的消化系统疾病患者，其中80位患有UGB临床表现。使用实时PCR系统对微生物的数量进行定量，该实时PCR系统利用内部对照扩增尿素酶基因以消除假阴性。对来自每个患者胃窦和胃体的活检样本进行处理。进行了快速尿素酶测试，培养，组织学研究，粪便抗原测试和呼气测试。金标准是至少两种其他技术中的阳性培养或阳性结果。如果将阳性结果定义为任何数量的微生物/人类细胞，则实时PCR的敏感性在出血患者中更高，尤其是在胃体中：68.4％（95％置信区间[CI]，52.3至84.5％）非UGB患者则为91.5％（95％CI为79.6至97.6％）。如果将阳性结果定义为超过使Youden指数最大化的最佳值的微生物/人细胞数量（胃腔中> 3.56微生物/人细胞，语料库中> 2.69），则UGB患者的敏感性和特异性均超过胃窦和体中80％。我们的发现表明，经典方法可能无法正确诊断出一些因幽门螺杆菌感染而出血的患者，这些患者可能会受益于实时PCR提供的改进诊断。但是，应评估经典测试中阴性结果患者中少量微生物的临床意义。

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