Beiping said | Discover Helicobacter pylori, which method is the most reliable?

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The spleen and stomach are the basis of the day after tomorrow. The spleen and stomach plays an important role in maintaining physical health.

Zhang Beiping, chief physician of the Department of Spleen and Stomach Diseases of Guangdong Provincial Hospital of Traditional Chinese Medicine, and the Integrated Traditional Chinese and Western Medicine Prevention Team of the Gastrointestinal Cancer will regularly push the knowledge of health care and Chinese and Western medicine to escort your digestive health through this column to escort your digestive and health! Welcome to follow.

Xiao Chen occasionally had bloating and stomach pain. Hearing colleagues said that Helicobacter Pylori (HP) was infected. The company's recent medical examination just included this project. The medical examination blood test HP antibody was negative. I wondered but saw that the result was okay, so I didn't take it to my heart, but in the past week, I bloated and stomach pain frequently, and the degree increased.

So Xiao Chen came to the Department of spleen and stomach disease in Guangdong Provincial Hospital of Traditional Chinese Medicine. After a careful question, the doctor suspected that the gastritis caused by HP infection caused the stomach and stomach pain. , Prompt HP infection! Thinking of her blood shortly ago, I had a blood test that HP antibodies were negative. Xiao Chen didn't know which result should be believed?

The doctor told Xiao Chen that the sensitivity and specificity of HP diagnosis of HP antibody diagnosis of HP antibody was lower than that of 13C urea exhalation tests. Even if the serum antibody detection results are negative, they cannot completely exclude HP infection. If necessary, it is necessary to combine gastroscopy, tissue biopsy, or 14C/13C urea exhalation test comprehensive judgment.

The doctor prescribed Xiao Chen's medicine to regulate the HP four -link scheme. After taking 2 weeks, Xiao Chen's stomach bloated and stomach pain was significantly relieved. After the end of the medication, Xiao Chen reviewed the 13C urea exhalation test. HP has been eliminated.

【【Beiping said】】

1. What is HP infection

HP infection is the most common cause of chronic gastritis in clinical practice. About 50%of the world's population has infected HP. At present, HP has been listed as Class I carcinogens. HP is closely related to various digestive system diseases, including chronic gastritis, gastric ulcers, duodenal ulcers, gastric cancer, gastric malt lymphoma; other system diseases such as chronic urtication of dermatology department such as dermatology department Merrobasi, and blood system diseases such as specialty platelet reduction purpura, iron deficiency anemia, etc. are also related to HP.

2. What are the methods of HP detection?

HP detection technology has been continuously updated, mainly including urea exhaling tests, rapid urea tests, feces antigen detection, serum examination, endoscopic examination, historical examination, bacterial culture, and HP -related gene testing. Among them, HP antibodies, urea exhalation tests and tissue examination are the most commonly used test methods in the clinic.

1.HP antibody detection

The principle of HP antibody detection is the corresponding antibody produced by the body's HP surface antigen stimulation. Based on this, the corresponding antibody is detected by multiple methods. This method is not affected by clinical medication, digestive tract bleeding, etc., and is applied more in crowd screening and epidemic survey. However, for patients with HP eradication, due to the long -term existence of serum antibodies, it cannot be used to confirm the infection and follow -up of the disease.

If the detected person has not received HP eradication treatment, HP antibody positive can be regarded as infection. Digestive ulcer bleeding, gastric malt lymphoma, and severe atrophy of gastric mucosa have HP test interference factors or small amount of gastric mucosa HP bacteria. At this time, other methods can be used Affected by these factors, HP antibody positive can also be regarded as infection.

2. Urea exhalation test

The urea exhaust test is the most used detection method. Its accuracy and specificity are high, and the operation is simple and non -invasive. However, there are some disadvantages of exhalation tests. If it is susceptible to clinical medication, the proton pump inhibitors need to be discontinued before testing for at least 2 weeks, and antibacterial drugs, pupae, and some traditional Chinese medicines with antibacterial effects are at least 4 weeks.

The exhalation test includes the 13C urea exhalation test and the 14C urea exhaust test. The accuracy of the two tests is not significantly different. The price of 14C is relatively low. However, considering that it is radioactivity, it is not suitable for children and pregnant women. Therefore The application is wider.

This test requires an empty stomach or fasting for more than 2 hours. After the first blowing sample is collected, the temperature of the test diagnostic reagent under the warm water service, then the second blow sampling after 30 minutes. The sample is checked and analyzed by the instrument.

Kind tips

Before testing:

1. Discontinue the proton pump inhibitors for more than 2 weeks, discontinue antibiotics and pyrine for more than 1 month

2. Acute gastrointestinal bleeding may cause test fake negatives

3. Review requires more than 4 weeks after the treatment is completed

4. Should be on an empty stomach or fast for more than 2 hours

checking:

You must not eat, drink water, smoke and exercise violently. You can eat after completing the second blow.

3. HP tissue examination

HP histological examination is a biopsy gastric mucosa under endoscopy, and HP stains HP through special dyeing technology, observed under a microscope to find its existence. However, due to the uneven distribution of HP in the stomach, it is affected by the biopsy site, quantity, and size, and the accuracy of biopsy in multiple parts is higher. At the same time, this method is also affected by factors such as biopsy tissue dyeing methods, operator experience levels, antibiotics and proton pump inhibitors. This method depends on endoscopic examination, can also judge the overall state of gastric mucosa at the same time, check whether there are diseases such as ulcers, atrophy, polyps, and tumors, and are suitable for people who need gastroscopy. 4. Others

HP feces antigen: HP can be quickly renewed and shed with the gastric mucosal epithelial cells. By detecting the feces antigen, you can understand whether there is HP infection, convenient operation, and suitable for any age, especially those with mental disorders, can be used for being used for them for it. The judgment of HP infection, root era effect, and large -scale epidemiological survey have certain application prospects.

Take HP's gastric mucosa tissue, in addition to the special dyeing of HP, you can also conduct a variety of methods such as fast urea test, bacterial culture, and PCR detection of HP -specific genes for testing.

HP infection diagnosis process

【Expert Introduction】

Zhang Beiping, a doctor of medicine, chief physician, doctoral tutor. Guangdong Provincial Hospital of Traditional Chinese Medicine (the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine) Deputy Director of the Department of Spleen and Stomach Diseases. The target of colleges and universities, the first batch of outstanding young medical talents in Guangdong Province, the second batch of outstanding Chinese medicine talents in Guangdong Province, was selected as the 8th batch of Lingnan famous medical records, and the first batch of Hu Run Ping An China good doctors in 2017.

Chairman of the Commission for Early Early Cancer Committee of the Chinese and Western Medicine Society of Chinese and Western Medicine Institute of Chinese and Western Medicine;

Chairman of the Professional Committee of Gastrointestinal Tumor Prevention and Control of the Guangdong Academy of Traditional Chinese Medicine;

Chairman of the Guangdong Health Society of Health and Health Association;

Good at: gastrointestinal, esophageal tumors and anterior cancer lesions, endoscopic diagnosis of endoscopic diseases with bile pancreas; combination of traditional Chinese and western medicine; endoscopic treatment of various digestive tract obstruction; inflammatory bowel disease (ulcerative colitis and Crole Grace) The combination of traditional Chinese and western medicine.

An introduction

The Department of Spleen and Stomach Diseases of Guangdong Provincial Hospital of Traditional Chinese Medicine is a key specialist at the 11th Fifth Chinese Medicine of the State Administration of Traditional Chinese Medicine, a key specialty of the Guangdong Provincial Administration of Traditional Chinese Medicine, the National Colorectal Patthrion Management Project Sub -Center, the National Capsule Endoscopy Research Center Guangzhou Sub -Center, Guangzhou Sub -Center. Lead the establishment of the Society of Chinese and Western Medicine Society of Chinese and Western Medicine Institute of Digestion of Endoscopy, Early Early Cancer Expert Committee, the Guangdong Provincial Society of Traditional Chinese Medicine Society, the Guangdong Provincial Chinese and Western Medicine Society Gastroscopy Professionals Professional committees, Lingnan Traditional Chinese Medicine Digestive Endoscopy Medical Alliance and Lingnan (South China) Chinese and Western Medicine Integrated Cynefront Clear Screw -related Stomach Diseases Academic Alliance

Under the guidance of the three professors of the academic leader Yu Shaoyuan, Luo Yunjian and Huang Suiping, under the leadership of the subject leader, the director of the spleen and stomach disease and digestive endoscopic center, Zhang Haiyan, Director of the Department of Spleen and Stomach Diseases of Dade Road General Hospital Wang Jing, director of the Department of Spleen and Stomach Diseases, and Chen Yan, Director of the Department of Spleen and Stomach Diseases of Fangcun Hospital, and Liu Tianwen, Director of the Department of Spleen and Stomach Diseases of the University City Hospital, led the team. Traditional Chinese and Western medicine combined methods to prevent early cancer of digestive tract and inflammatory cancer, such as chronic atrophic gastritis, colorectal adenomas, inflammatory bowel diseases, bilerstroba diseases, etc., especially at 3E technology (ESD, ERCP, EUS) under digestive endoscopy (ESD, ERCP, EUS). Waiting for various surgical treatment and postoperative Chinese medicine to promote rehabilitation and achieve good clinical effects, they are welcomed by patients.

Supply: Wu Shaohua Fu Lingyu Zhong Ca Ling

Executive editor: Wu Yuan Tuan

Audit school pair: Zhuang Yingge

Editor in charge: Song Liping

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