Acta Endoscopica

, Volume 43, Issue 1–2, pp 14–18 | Cite as

Performances diagnostiques du test rapide à l’uréase dans la détection de l’infection à Helicobacter pylori en période hémorragique

  • N. Lahmidani
  • N. Aqodad
  • M. ElYousfi
  • I. Mellouki
  • M. ElAbkari
  • A. Ibrahimi
  • D. Benajah
Article Original / Original Article
  • 100 Downloads

Résumé

Introduction

Le test rapide à l’uréase (TRU) est considéré comme l’un des moyens diagnostiques de première ligne de l’infection à Helicobacter pylori chez les patients bénéficiant d’une endoscopie haute, et cela grâce à sa grande spécificité et sensibilité, son coût et sa reproductibilité par rapport à l’étude histologique. Cependant, un grand nombre d’études suggèrent que la sensibilité du TRU diminue significativement chez les patients présentant un ulcère gastroduodénal hémorragique. Le but de notre étude était d’évaluer les performances diagnostiques du TRU dans le diagnostic de l’infection à H. pylori dans l’ulcère bulbaire en période hémorragique.

Matériels et méthodes

Notre travail est une étude prospective de type transversal portant sur des patients hospitalisés pour ulcère bulbaire hémorragique, conduite au sein du service d’hépatogastroentérologie du CHU Hassan-II, étalée sur une période de deux ans et trois mois. Tous les malades inclus dans l’étude ont bénéficié de biopsies antrales avec recherche de l’infection à H. pylori au TRU et à l’histologie considérée comme gold standard.

Résultats

Cent seize patients porteurs d’ulcère bulbaire hémorragique étaient inclus. La sensibilité du TRU était de 72 % avec une valeur prédictive négative de 30 %, une spécificité de 88 % et une valeur prédictive positive de 97 %. La présence de sang dans l’estomac et la consommation des AINS étaient les principaux facteurs diminuant la sensibilité de ce test rapide.

Conclusion

Le TRU reste un test couramment utilisé en pratique pour le diagnostic de l’infection à H. pylori du fait de ces performances. En période hémorragique, la sensibilité du TRU diminue en présence de sang dans l’estomac et de la consommation d’AINS.

Mots clés

Test rapide à l’uréase Ulcère gastroduodénale Hémorragie Helicobacter pylori 

Accuracy of rapid urease test in the diagnosis of H. pylori during bleeding period

Abstract

Introduction

The rapid urease test is considered one of the primary diagnostics of Helicobacter pylori infection among patients undergoing upper endoscopy and thanks to its high sensitivity and specificity, cost and reproducibility compared with the histological study. However, many studies suggest that the sensitivity of rapid urease test decreased significantly in patients with bleeding peptic ulcer. The aim of our study is to evaluate the diagnostic performance of rapid urease test in the diagnosis of H. pylori infection in peptic ulcer during bleeding complication.

Materials and methods

Our work is a prospective study on patients hospitalized for bleeding peptic ulcer, conducted at the hepatogastroenterology unit of University Hospital Hassan II over a period of two years and three months. All patients included in the study have benefited from antral biopsies with search of H. pylori infection in rapid urease test (CLOtest) and histology.

Results

One hundred and sixteen patients with bleeding peptic ulcer were admitted during this period. The sensitivity of rapid urease test was 72% with a negative predictive value of 30%, specificity of 88% and positive predictive value of 97%. The presence of blood in the stomach and the consumption of nonsteroidal anti-inflammatory drugs (NSAIDs) were the major factors that decrease the sensitivity of this rapid test.

Conclusion

The rapid urease test is a test commonly used in practice for the diagnosis of H. pylori infection. Acute bleeding may be responsible for many false negatives due to the presence of blood in stomach and NSAIDs.

Keywords

Rapid urease test Bleeding Peptic ulcer H. pylori 

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Copyright information

© Springer-Verlag France 2013

Authors and Affiliations

  • N. Lahmidani
    • 1
  • N. Aqodad
    • 2
  • M. ElYousfi
    • 1
  • I. Mellouki
    • 1
  • M. ElAbkari
    • 1
  • A. Ibrahimi
    • 1
  • D. Benajah
    • 1
  1. 1.Service de gastroentérologieCHU Hassan-IIFèsMaroc
  2. 2.Service hépatogastroentérologieCHU Hassan-IIFèsMaroc

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