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ANALIZAN LA EXACTITUD DE LA PRUEBA DEL ALIENTO CON 13C-UREA PARA DIAGNOSTICO DE LA INFECCION POR H. PYLORI MEDIANTE ESPECTROMETRIA DE MASA Y ESPECTROFOTOMETRIA DE INFRARROJO

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La prueba del aliento con urea tiene una exactitud mayor del 90%, por lo que es superior al diagnóstico basado en el análisis de la muestra obtenida por biopsia.
gisbert9.jpg Autor:
Javier p. Gisbert
Columnista Experto de SIIC

Institución:
Hospital Universitario de la Princesa, Universidad Autónoma de Madrid

Artículos publicados por Javier p. Gisbert
Recepción del artículo
14 de Febrero, 2006 		Aprobación
4 de Mayo, 2006
Primera edición
3 de Julio, 2006 		Segunda edición, ampliada y corregida
7 de Junio, 2021

ANALIZAN LA EXACTITUD DE LA PRUEBA DEL ALIENTO CON 13C-UREA PARA DIAGNOSTICO DE LA INFECCION POR H. PYLORI MEDIANTE ESPECTROMETRIA DE MASA Y ESPECTROFOTOMETRIA DE INFRARROJO

Resumen
La prueba del aliento con urea (PAU) se basa en la capacidad de la ureasa producida por H. pylori para hidrolizar una solución de urea previamente marcada con el isótopo 13C o 14C. La utilización de 13C comporta indudables ventajas, ya que se trata de un isótopo natural estable y no radiactivo. La PAU es considerada actualmente como la técnica de elección para confirmar la erradicación de H. pylori (cuando no es precisa la gastroscopia), lo que deberá comprobarse al menos cuatro semanas después de haber finalizado el tratamiento antibiótico. La exactitud diagnóstica de la PAU es muy elevada, superior al 90%, probablemente debido a que valora la totalidad de la mucosa gástrica, a diferencia de los métodos diagnósticos basados en el análisis de la muestra obtenida por biopsia. Para la realización de la PAU se emplea tradicionalmente un espectrómetro de masas de relaciones isotópicas (isotope ratio mass spectrometer [IRMS]). Más recientemente se desarrollaron otras técnicas, entre las que destaca la espectrofotometría de infrarrojos (NDIRS). Ambos equipos poseen una similar y elevada exactitud diagnóstica. La utilización del IRMS podría ser más apropiada en hospitales donde se realicen numerosas pruebas del aliento o en aquellos sitios que actúen como centros de referencia para la recepción de muestras procedentes de otros lugares. El NDIRS, por su parte, constituye una atractiva alternativa para los laboratorios que procesan un reducido número de muestras o para el uso en la propia consulta.

Palabras clave
helicobacter pylori, diagnóstico, prueba del aliento, 13C-urea, espectrómetro de masas, infrarrojos


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Especialidades
Principal: Gastroenterología
Relacionadas: Bioquímica, Diagnóstico por Laboratorio, Infectología, Medicina Interna



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Enviar correspondencia a:
Javier P. Gisbert, Servicio de Aparato Digestivo, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, 28669, Playa de Mojácar 29, Urb. Bonanza, Boadilla del Monte, Madrid, España
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