基于大剂量枸橼酸的^(13)C尿素呼气试验确定三联治疗14d后幽门螺杆菌是否根除

作     者：Shirin H. Levine A. Shevah O. 徐瑞 

作者机构：Department of Gastroenterology E. Wolfson Medical Center IL-58100 Holon Israel Dr. 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2006年第2卷第1期

页      面：14-15页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：三联治疗 尿素呼气试验 枸橼酸 假阴性率 阳性预测率 短期治疗 金标准 特异性 

摘      要：Background: Confirmation of Helicobacter pylori eradication by urea breath test (UBT) is currently performed 4- 6 weeks after completion of therapy because of unacceptable false-negative results in UBTs performed earlier. Use of a high- dose citric acid test meal appears to enable accurate detection of H. pylori even during short term therapy with proton pump inhibitors. Aim: To evaluate if use of a high dose citric acid (4.0 g) test meal can decrease the interval required for confirmation of eradication after triple therapy. Methods: 233 patients positive for H. pylori were randomized to undergo UBT at 7 days or 14 days after triple therapy, and again at 6 weeks. The latter test was considered the gold standard test. Results: The UBT performed 6 weeks after the end of treatment found that 79.9% were cured. The same test 7 days after therapy found false negative detection of H. pylori in 7.3% patients compared to 3.2% patients examined after 14 days. The sensitivity, specificity, positive and negative predictive values and accuracy for evaluation on day 14 were 80,100, 100, 96.3 and 96.7% , respectively. Conclusions: High- dose citric acid- based UBT is a valid test for the assessment of H. pylori status 14 days after triple therapy. This may obviate the delay in instituting second- line eradication therapy, or further evaluation of the symptomatic patient unresponsive to therapy despite eradication.