Primerjava rezultatov dihalnega testa za določanje bakterije Helicobacter pylori in antigena v blatu : univerzitetni študij farmacije

Lešnik, Mojca (author), Osredkar, Joško (mentor)

Bakterija Helicobacter pylori (H. pylori) je odgovorna za razvoj različnih bolezni zgornjega dela prebavil, vključno z rakom želodca. Okužba z njo je zelo vztrajna in lahko traja celo življenje. Zgodnje odkrivanje in zdravljenje te okužbe ima zato velik pomen. Za ugotavljanje prisotnosti te bakterije v človeškem želodcu in spremljanje uspešnosti protimikrobne terapije imamo na voljo več različnih diagnostičnih metod. Z namenom ovrednotiti diagnostično uporabnost testov določanja H. pylori antigena v blatu smo zbrali podatke o 100 pacientih v starosti od 10 do 85 let. Ugotavljali smo diagnostične vrednosti (občutljivost, specifičnost, pozitivno in negativno napovedno vrednost ter točnost) kvalitativne in kvantitativne metode določanja H. pylori antigena v blatu v primerjavi z dihalnim testom s sečnino ter povezavo med kvalitativnimi vrednostmi določanja H. pylori antigena v blatu in koncentracijo H. pylori antigena v blatu. Z raziskavo smo hoteli ugotoviti, ali lahko metoda določanja H. pylori antigena v blatu nadomesti do sedaj uporabljano metodo – dihalni test s sečnino.Na naši skupini bolnikov smo ugotovili 90,32% občutljivost in 81,40% specifičnost ImmunoCard STAT! HpSA testa za kvalitativno določanje H. pylori antigena v blatu. Njegova pozitivna napovedna vrednost je 77,78%, negativna napovedna vrednost 92,11% in točnost 85,14%. Občutljivost DRG® Helicobacter Pylori Ag (stool) ELISA testa za kvantitativno določanje H. pylori antigena v blatu je 87,10%, specifičnost 97,67%, pozitivna napovedna vrednost znaša 96,43%, negativna napovedna vrednost 91,30% in točnost 93,24%. Pri kvalitativnem testu smo izračunali razmejitveno vrednost 0,910 μg/l. Z raziskavo smo dokazali, da sta oba testa določanja H. pylori antigena v blatu primerljiva z dihalnim testom s sečnino, zaradi česar se lahko uporabljata kot njegov cenejši nadomestek pri ocenjevanju uspešnosti protimikrobne terapije proti H. pylori. Testa sta primerljiva tudi med seboj, vendar služi kvalitativen test le za ugotavljanje prisotnosti bakterije, s kvantitativnim testom pa določimo tudi količino prisotne bakterije.

• Language: Slovenian
• Keywords: dihalni testi diagnostika okužbe zdravljenje okužbe diagnostični testi antigeni v blatu kvantitativni test
• Work type: Undergraduate thesis
• Typology: 2.11 - Undergraduate Thesis
• Organization: FFA - Faculty of Pharmacy
• Place of publishing: Ljubljana
• Publisher: [M. Lešnik]
• Year: 2015
• Number of pages: VII, 59 f.
• PID: 20.500.12556/RUL-121030
• UDC: 616-074(043.2)
• COBISS.SI-ID: 3807345
• Publication date in RUL: 29.09.2020

Secondary language

• Language: English
• Title: Comparison of the results fo breath test for determination of Helicobacter pylori and antigen in stool

Abstract

Helicobacter pylori (H. pylori) bacterium is responsible for the development of various diseases of the upper gastrointestinal tract, including cancer of the stomach. Infection can be very resilient and can last a lifetime. Therefore early detection and treatment of this infection is of great importance. There are several different methods of diagnosis which can be used to detect the presence of this bacterium in the human stomach and to monitor the success of antimicrobial therapy. In order to evaluate the diagnostic utility of testing for the determination of H. pylori antigen in stool we collected data on 100 patients aged 10 to 85 years. We assessed the diagnostic values (sensitivity, specificity, positive and negative predictive value and accuracy) qualitative and quantitative methods for the determination of H. pylori antigen in stool compared with the urea breath test and the link between the values of qualitative determination of H. pylori antigen in stool and the concentration of H. pylori antigen in stool. With this research, we wanted to determine whether the method of determining the H. pylori antigen in stool can replace the urea breath test used so far. On our group of patients, we found 90,32% sensitivity and 81,40% specificity of ImmunoCard STAT! HpSA test for the qualitative determination of H. pylori antigen in stool. Its positive predictive value was 77,78%, negative predictive value of 92,11% and accuracy 85,14%. The sensitivity of Helicobacter Pylori DRG® Ag (stool) ELISA test for the determination of H. pylori antigen in stool is 87,10% and specificity 97,67%, positive predictive value is 96,43%, negative predictive value of 91,30% and accuracy 93,24%. In the qualitative test we calculated cut-off value of 0,910 μg/l. With this research we demonstrated that both tests intended for determining the presence of H. pylori antigen in stool, are comparable with the urea breath test, and can therefore be used as a cheaper substitute in assessment of the effectiveness of antimicrobial therapy against H. pylori. Tests are also comparable with each other; however, the qualitative test serves only for the detection of bacteria, whereas the quantitative test also determines the amount of bacterium present.