口腔幽门螺杆菌尿素酶的检测及其临床意义
The Clinical Value of Oral H. Pylori Antigen Test
DOI: 10.12677/MD.2012.24005, PDF, HTML, XML, 下载: 3,456  浏览: 13,183 
作者: 叶国钦*:螺旋杆菌研究所,西雅图,美国
关键词: 幽门螺杆菌检测方法HPSH. Pylori; Diagnosis Method; HPS
摘要: 幽门螺杆菌(Hp)感染诊断方法很多,各种诊断方法有其各自的特点,但传统Hp感染的诊断方法,主要适用于胃Hp感染的检测,对口腔Hp感染难以做出稳定的检测结果,甚至存在检测盲区。唾液幽门螺杆菌抗原测试板(HPS),是应用胶体金层析式双抗体夹心法技术,采用Hp尿素酶单克隆抗体,定性检测人体唾液中相应Hp产生的尿素酶,主要应用于口腔Hp感染的检测,具有较高的敏感性和特异性,操作简便、快捷,可在实验室外进行检测等特点。HPSUBT联合检测,可大致区分口腔Hp感染合并胃Hp感染、单纯口腔Hp感染、单纯胃Hp感染,为临床制定更完善的、全新的Hp根除方案提供实验诊断依据。 There are number of diagnostic methods detecting Helicobacter pylori (H. pylori) infection. Each has their own character, however standard diagnosis technology apply in detecting H. pylori infection of stomach, not suitable for diagnosis of oral infection. For example, C13, C14 UBT test had been utilized as a gold standard for diagnosis of H. pylori infection in stomach more than two decades, however they have blinded zone detecting oral H. pylori infection. A simple noninvasive, new technology, H. pylori saliva antigen test (HPS) to detecting oral infection with a clean view of the line linking oral and stomach H. pylori infection. HPS is a sandwich immunoassay test, which utilizes an unique antibodies to selectively identify H. pylori Urease in saliva. The HPS technology has high sensitivity and specificity. It is very simple procedure of test and the results can be obtained within few minutes. It is suitable for lab use and over the counter. The combination uses of HPS and UBT can classify both oral and stomach infection, or simple oral infection or simple stomach infection. By this technology we can make an revolutionary treatment plan for cure H. pylori infection.
文章引用:叶国钦. 口腔幽门螺杆菌尿素酶的检测及其临床意义[J]. 医学诊断, 2012, 2(4): 23-29. http://dx.doi.org/10.12677/MD.2012.24005

参考文献

[1] 刘娅玲, 胡涛, 张静仪等. 内氏放线菌尿素酶对牙菌斑生物膜酸碱平衡调节作用的初步研究[J]. 上海口腔医学, 2005, 6(14): 605-607.
[2] Y. Y. Chen, R. A. Burne. Identification and characterization of the nickel uptake system for urease biogenesis in S-treptococcus salivarius 57.I. Journal of Bacteriology, 2003, 185: 6773-6779.
[3] 赵圣国, 王加启, 卜登攀等. 细菌尿素酶的生化和分子生物学特点[J]. 微生物学通报, 2008, 34(35): 1146-1152.
[4] M. Shu, E. Morou-Bermudez, E. Surez-Pérez, et al. The relationship between dental caries status and dental plaque urease activily. Oral Microbiology and Immunology, 2007, 22(1): 61- 66.
[5] M. M. Nascimento, V. V. Gordan, C. W. Garvan, et al. Correlations of oral bacterial arginine and urea catabolism with caries experience. Oral Microbiology and Immunology, 2009, 24(2): 89-95.
[6] E. Toro, M. M. Nascimento, E. Surez-Pérez, et al. The effect of sucrose on plaque and saliva urease levels in vivo. Archives of Oral Biology, 2010, 55(3): 249-254.
[7] A. J. Degnan, W. C. Sonzogni and J. H. Standridge. Development of a plating medium for selection of Helicobacter pylori from water samples. Applied and Environmental Microbiology, 2003, 69(5): 2914-2918.
[8] 陈瑞川, 吴艳环, 张长弓等. 纳氏测氨法半定量诊断HP感染的方法及其应用[J]. 厦门大学学报(自然科学版), 1997, 36: 647-651.
[9] 徐智民, 张万岱, 周殿元. 幽门螺杆菌的研究进展[J].世界华人消化杂志, 2003, 11: 635-639.
[10] 俞莹莹, 吴勤动, 许凯声等. 唾液幽门螺杆菌抗原检测与慢性胃炎活动性及癌前期病变关系的研究[J]. 中国实用内科杂志, 2006, 26: 1421-1423.
[11] 叶国钦. 螺旋杆菌临床研究新进展[M]. 北京: 人民卫生出版社, 2010: 56-71, 171-178, 179-195.
[12] J. Yakoob, S. Abid, Z. Abbas, et al. Distribution of Helicobacter pylori virulence markers in patients with gastroduodenal diseases in Pakistan. BMC Gastroenterology, 2009, 9(1): 87.
[13] M. Demir, H. S. Gokturk, N. A. Ozturk, et al. Clarithromycin resistance and efficacy of clarithromycin-containing triple eradication therapy for Helicobacter pylori infection in type 2 diabetes mellitus patients. Southern Medical Journal, 2009, 102: 1116-1120.
[14] 代敏, 段广才, 郗园林等. RAPD法对50株幽门螺杆菌的分子流行病学[J]. 疾病控制杂志, 2002, 3(6): 12-14.
[15] V. De Francesco, A. Zullo, E. Ierardi, et al. Phenotypic and genotypic Helicobacter pylori clarithromycin resistance and therapeutic outcome: Benefits and limits. Journal of Antimicrobial Chemotherapy, 2010, 65(2): 327-332.
[16] 谭昌成, 施理. 幽门螺杆菌临床分离株尿素酶基因及活性多样性[J]. 现代消化及介入诊疗, 2008, 6(13): 18-21.
[17] 叶国钦. 唾液幽门螺杆菌抗原检测法——HPS的临床应用评价[J]. 中国医疗前沿, 2009, 4(20): 18-19.
[18] 叶国钦, F. Karin, T. Noriko等. 口腔幽门螺杆菌感染与胃幽门螺杆菌感染相关性探讨[J]. 中华消化杂志, 2011, 30(31): 38-41.
[19] 楼晓军, 楼雅依, 陈晓琴等. 唾液测试板检测幽门螺杆菌的临床价值[J]. 中国内镜杂志, 2009, 14(15): 886-888.
[20] 郝庆, 宋军民, 李岩. 幽门螺杆菌唾液测试板与14C尿素呼气试验的比较研究[J]. 中华消化杂志, 2010, 30: 628-629.
[21] 张晶, 徐樨巍, 丁召路等. 口腔唾液幽门螺杆菌测试板的临床筛查价值研究[J]. 医学综述, 2011, 34(17): 2696-2698.
[22] 叶国钦. 口腔幽门螺杆菌感染的临床检测[J]. 中华医学杂志, 2012, 92: 1084-1086.
[23] R. P. Allaker, K. A. Young, J. M. Hardie, et al. Prevalence of Helicobacter pylori at oral and gastrointestinal sites in children: evidence for possible oral to oral transmission. Journal of Medical Microbiology, 2002, 51(4): 312-317.
[24] A. Eskandari, A. Mahmoudpour, N. Abolfazli, et al. Detection of Helicobacter pylori using PCR in dental plaque of patients with and without gastritis. Medicina Oral Patologia Oral y Cirugia Bucal, 2010, 15(1): e28-e31.
[25] H. Miyabayashi, K. Furhata, T. Shimizu, et al. Influence of oral Helicobacter pylori—The success of eradication therapy against gastric Helicobacter pylori. Helicobacter, 2000, 5(1): 30-37.
[26] 侯海玲, 孟焕新, 胡文杰等. 口腔幽门螺杆菌对胃幽门螺杆菌根除的影响[J]. 中华口腔医学杂志, 2003, 38: 237-239.
[27] 高静, 王庆才, 高德安等. 慢性胃炎患者口腔幽门螺杆菌对胃幽门螺杆菌根除率的影响[J]. 中华消化杂志, 2010, 31(30): 630-631.
[28] M. Gzesnikiewicz-Guzik, B. Lofter, W. Bielanski, et al. Implication of oral Helicobacter pylori for the outcome of its gastric e radioation therapy. Journal of Clinical Gastroenterology, 2007, 41: 145-151.
[29] S. A. Dowsett, M. J. Kowolik. Oral Helicobacter pylori: Can we stomach it? Critical Reviews in Oral Biology, 2003, 14(3): 226-233.
[30] 高文, 胡伏莲, 王晓敏. 含呋喃唑酮的四联疗法联合口腔洁治对幽门螺杆菌根除多次失败的补救治疗[J]. 中华医学杂志, 2011, 91: 836-839.
[31] 叶国钦, 叶小钦, 叶小培等. 多聚赖氨酸复合体治疗口腔幽门螺杆菌感染的疗效观察[J]. 中国医疗前沿, 2010, 5: 1-4.
[32] 叶国钦. 口腔幽门螺杆菌感染的处理策略——必须面对的一个重要问题[J]. 中华医学杂志, 2012, 92(10): 659-661.
[33] 叶国钦. 幽门螺杆菌处理策略——必须针对胃与口腔同步进行综合干预[J]. 中国医学论坛报, 2012, 38(3): D3-D4.
[34] 叶国钦. 探索清除口腔幽门螺杆菌的几条思路[J].中华医学杂志, 2012, 92(40): 2811-2813.