幽门螺杆菌菌株类型与儿童胃窦黏膜炎症程度及细菌定植密度的关系  

Relationship between types of Helicobacter pylori strain and the severity of inflammation and the density of bacterial colonization in antral mucosa in children

作　　者：胡伟国[1] 徐彰[1] 陶洪群[1] 朱欢[1] 黄开宇[1] 徐辉[1] 黄爱芬[1] 程芹芹[1] 谢小志[1] 

机构地区：[1]浙江温州医学院附属育英儿童医院,325000

出　　处：《临床医学》2005年第6期7-9,共3页Clinical Medicine

基　　金：温州市科技发展计划项目(项目编号S2002A039)

摘　　要：目的探讨幽门螺杆菌(H.pylori)菌株类型与儿童胃窦黏膜炎症程度及H.pylori定植密度的关系。方法采用免疫印迹法测定134例H.pylori感染患儿血清细胞毒素相关蛋白(CagA)、空泡毒素(VacA)抗体,对H.pylori进行血清学菌株分型,并行胃镜检查,取胃窦黏膜经HE及改良Giemsa染色后观察胃窦黏膜炎症程度及H.pylori定植密度。结果CagA、VacA抗体总检出率分别为85.07%(114/134)、91.04%(122/134),检出H.pyloriⅠ型菌株113例,Ⅱ型菌株11例,中间型菌株10例,各型菌株感染引起胃窦黏膜中重度炎症分别为100例(88.50%),5例(45.45%),5例(50.00%),差异有显著性(H=20.048,P=0.000);110例胃窦黏膜检有H.pylori,其中H.pylori定植密度“+”63例(57.27%),“++”32例(29.09%),“+++”15例(13.64%),H.pylori各型菌株患儿胃窦黏膜H.pylori定植密度无明显差异(H=1.366,P=0.505)。结论H.pylori菌株类型与儿童胃窦黏膜炎症程度有关,而与H.pylori定植密度无关,Ⅰ型菌株能引起胃窦黏膜较重的炎症。Objective To explore the relationship between types of Helicobacter pylori strain and the severity of inflammation and the density of Helicobacter pylori colonization in antral mucosa in children.Methods The serum CagA and VacA antibodies were measured by the immune blotting method in 134 children with Helicobacter pylori infection to confirm types of Helicobacter pylori .The gastric biopsy specimens of all children were studied histologically. Results The total detection rate of CagA and VacA antibody was 85.07%(114/134) and 91.04%(122/134) respectively in all cases,The detection rate of gastric mucosal moderate-severe inflammation was (88.50% (100/113) in children with both CagA and VagA antibody positive (Helicobacter pylori type Ⅰ strains),and was 45.45%(5/11) and 50.00%(5/10) in children with both CagA and VagA antibody negative (Helicobacter pylori type Ⅱ strains)and either CagA or VagA antibody positive(Helicobacter pylori intermediate type strains) respectively.There were very significant differences between types of Helicobacter pylori strain (H=20.048,P=0.000). 110 cases were found Helicobacter pylori positive in antral mucosa,there was no significant difference in the Helicobacter pylori colonization density between types of Helicobacter pylori strain (H=1.366,P=0.505). Conclusion The severity of antral mucosal inflammation correlated with types of Helicobacter pylori strain ,but not with the H.pylori colonization density.Helicobacter pylori type Ⅰstrains may cause more severe inflammation in gastric mucosa.

关 键 词：胃窦黏膜 定植密度 幽门螺杆菌 炎症程度 儿童 H.pylori感染 改良Giemsa染色 细胞毒素相关蛋白 pylori) 细菌 VacA抗体 免疫印迹法 黏膜炎症 菌株分型 胃镜检查 CagA 总检出率 血清学 中间型 显著性 患儿 Ⅰ型 

分 类 号：R725.7[医药卫生—儿科]