Usefulness of serological IgG antibody determinations for confirming eradication of Helicobacter pylori infection
Usefulness of serological IgG antibody determinations for confirming eradication of Helicobacter pylori infection
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DOI：
10.1111/j.1572-0241.1999.01285.x
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发表时间：
1999-08-01
影响因子：
9.8
通讯作者：
Peura, DA
中科院分区：
文献类型：
--
作者：
Marchildon, P;Balaban, DH;Peura, DA
目的：先前的研究表明，IgG抗体滴度可能有助于确认幽门螺杆菌（H。pylori）感染。然而，IgG滴度降低的诊断价值受到必须平行进行治疗前和治疗后测试的限制，这需要储存血清。我们的目的是评估使用HM-CAP IgG EIA试剂盒（Enteric Products）检测IgG抗体滴度在监测H.方法：采用C-14尿素呼气试验（UBT）检测幽门螺杆菌（H. pylori）感染。83例消化不良患者治疗后4 wk和6个月pylori感染和根除。治疗前和治疗后6个月的IgG滴度连续测定（单独的EIA板）或平行测定（相同的ELA板），并计算抗体滴度的相对下降百分比。幽门螺杆菌根除，系列和平行测定的平均敏感性分别为87.5%和86.8%，两者的平均特异性均为100%。在68 75例患者的有机体被根除，在6个月的平均下降IgG滴度为41.1%的系列测定和41.5%的平行determinations.Conclusions：系列或平行IgG滴度提供相同的诊断准确性确认H。治疗后根除幽门螺杆菌。治疗后6个月滴度下降大于或等于25%是根除感染的敏感和特异性标志。IgG滴度的系列评价不需要血清储存，并且是UBT或基于内窥镜的方法的具有成本效益且准确的替代方法。(Am胃肠病学杂志1999;94：2105-2108. (C)1999年，我胃肠病学）。
OBJECTIVE: Prior studies have suggested that IgG antibody titers may be useful to confirm successful treatment of Helicobacter pylori (H. pylori) infection. However, the diagnostic value of decreasing IgG titers is limited by the necessity to perform pre and posttreatment tests in parallel which requires stored sera. Our objective was to assess the accuracy of IgG antibody titers using the HM-CAP IgG EIA kit (Enteric Products) in monitoring treatment of H. pylori infection and to compare the relative accuracy of parallel versus serial determinations.METHODS: The C-14 urea breath test (UBT) was used to confirm H. pylori infection in 83 dyspeptic patients and eradication of the organism at 4 wk and 6 months posttreatment. IgG titers pretherapy and 6 months posttherapy were determined either serially (separate EIA plates) or in parallel (same ELA plate), and the relative percent decline in antibody titer was calculated.RESULTS: When a decline of greater than or equal to 25% at 6 months was used as the cut-off for H. pylori eradication, mean sensitivities of serial and parallel determinations were 87.5% and 86.8%, respectively, and mean specificities of both were 100%. In 68 of 75 patients in whom the organism was eradicated, the mean decrease in IgG titer at 6 months was 41.1% for serial determinations and 41.5% for parallel determinations.CONCLUSIONS: Serial or parallel IgG titers offer equivalent diagnostic accuracy for confirming H. pylori eradication after therapy. A greater than or equal to 25% decline in titer 6 months after therapy is a sensitive and specific marker for eradication of the infection. Serial evaluation of IgG titers does not require serum storage, and is a cost-effective and accurate alternative to the UBT or endoscopy-based methods. (Am J Gastroenterol 1999;94:2105-2108. (C) 1999 by Am. Coll. of Gastroenterology).