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Gastric juice for the diagnosis of H pylori infection in patients on proton pump inhibitors

查看全文 作　　者：Javed [1]Yakoob;Shahid [1]Rasool;Zaigham [1]Abbas;Wasim [1]Jafri;Shahab [1]Abid;Muhammad [1]Islam;Zubair [2]Ahmad 高影响力作者 机构地区：[1]Department of Medicine, Aga Khan University Hospital, Karachi 74800, Pakistan;[2]Department of Pathology, Aga Khan University Hospital, Karachi 74800, Pakistan高影响力机构 出　　处：《World Journal of Gastroenterology》索引2008年第14卷第10期,共5页高影响力期刊 基　　金：The research grants from Aga Khan University Research Committee to JY and SR 摘　　要：AIM: To determine the efficacy of gastric juice polymerase chain reaction (PCR) for the detection of H pylori infection in comparison with histology and gastric antral biopsy PCR in patients on a proton pump inhibitor (PPI). METHODS: Eighty-five consecutive patients with dyspeptic symptoms were enrolled. Gastric biopsies for histology, PCR and gastric juice were collected at endoscopy for PCR of the H pylori urease C gene (ure C). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, positive and negative likelihood ratio for PCR of gastric juice for the H pylori ure C gene was compared to histology and gastric antral biopsy H pylori ure C PCR in patients with and without PPI. RESULTS: Gastric juice PCR was positive in 66 (78%) patients. Histology showed H pylori associated gastritis in 57 (67%). Gastric biopsy PCR was positive in 72 (85%). In patients not taking PPI, the sensitivity, specificity, PPV, NPV, accuracy and positive and negative likelihood ratio for gastric juice PCR were 89%, 72%, 91%, 67%, 90%, 85%, 3.1 and 0.1 respectively. In patients on PPI these values were 86%, 100%%, 100%, 29%, 86%, 9.5 and 1.4, respectively. CONCLUSION: Gastric juice PCR for the diagnosis of H pylori infection has increased sensitivity compared to histology with PPI. The use of gastric juice PCR is recommended to confirm H pylori status in patients taking PPIs. 关 键 词：幽门杆菌 质子泵抑制剂 胃汁 聚合酶联反应
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