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題名 | Evaluation of Topographic Gastric Histology in H. Pylori Infection--A Comparative Study with CLO Test and Bacterial Culture=胃內不同解剖位置的組織切片在幽門螺旋菌感染的臨床價值並和尿素酵素反應測試及細菌培養等診斷技術做比較 |
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作者 | 楊曉白; 許博翔; 簡崇和; 黃愛惠; 謝淑珠; 林錫璋; 吳俊忠; 蘇益仁; | 書刊名 | 慈濟醫學 |
卷期 | 10:3 1998.09[民87.09] |
頁次 | 頁165-173 |
分類號 | 414.83 |
關鍵詞 | 幽門螺旋菌; 內視鏡生體檢查; 組織切片; 取樣位置; 尿素酵素反應測試; 細菌培養; Helicobacter pylori; Topographic biopsy; Mucosal rapid urease text; CLO text; Histology; Culture; |
語文 | 英文(English) |
中文摘要 | 內視鏡生體檢查可以瞭解幽門螺旋菌感染的情形。本篇的目的是探討取樣的適當 個數及位置,並比較各種侵襲檢查(內視鏡生體組織切片檢查、尿素酵素反應測試[CLO test]、 細菌培養)的可靠性,試圖澄清之間的差異。47位消化不良且未經藥物治療的病人(25位 男性、22位女性)進入本研究,每人經內視鏡在胃內六個不同位置(包括胃竇部的小彎及 彎側、胃角、胃體部、高體部的小彎近賁門處及大彎側)採得標本做組織切片檢查。在胃竇 部取一標本做尿素酵素反應測試,另外在胃竇及胃角取了三塊做細菌培養。依據組織切片檢 查結果,34位病人(72.3%)患有幽門螺旋菌感染,而尿素酵素反應測試和細菌培養的敏感性 及特異性分別是91.2% & 100%,79.4% & 100%。尿素酵素反應測試是一個省時又可靠的檢 定方法。幽門螺旋菌的分佈大多十分廣泛但不平均,其中有三位細菌量很少且只在胃角及高 體部發現,因而尿素酵素反應試測不到。此外菌量太少或污染菌太多都可能導致陰性細菌培 養結果。若結合細菌感染及組織發炎的嚴重程度來評估取樣位置,則以胃竇部小彎側最具代 表性。由胃各部位組織切片發現最少三個切片,取樣位置包含胃竇部小彎側、胃角及高體部 近賁門處最理想。 |
英文摘要 | Endoscopic biopsy is an effective method for the diagnasis of Helicobacter pylori infection. This study sought to determine suitable biopsy locations of Helicobacter pylori infection. This study sought to determine suitable biopsy locations and the optimal number of specimens for histology examination and to clarify the discrepancies among various invasive diagnostic tests. Forty-seven dyspeptic patients (25 M, 22 F) were topographically sampled for histology, mucosal rapid urease (CLO) test and bacterial culture. Based on histology, 34 patients (72.3%) had H. pylori infection. The sensitivity and specificity of the CLO test and culture were 91.2% & 100% and 79.4% & 100%, respectively. CLO test is known to be a reliable method for the diagnosis of H. pylori infection. In this study, the distribution of H. pylori varied in the stomach and the uneven distribution of bacteria may be responsible for the discrepancy in the diagnostic yield. There were 3 patients with a low bacterial load which was confined to the angle or high body of the stomach and with negative CLO test in the antrum. We recommend that at least three biopsies for histology including the antrum of the lesser curvature side, angle and higher body (near cardia), should be sampled to improve the diagnostic accuracy of H. pylori infection and inflammation activity. |
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