十二指肠球部溃疡患者幽门螺杆菌感染的表型特征及其意义  

Characteristic typing of Hellcobacter pylori phenotypes and its clinical significance in patients with duodenal bulb ulcers

作　　者：吴炎[1] 林木贤[1] 赵娅敏[1] 康文全[1] 高燕[1] 张厚德[1] 

机构地区：[1]广东医学院附属深圳南山医院消化科,518052

出　　处：《中国医师进修杂志（内科版）》2008年第11期12-14,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的研究十二指肠球部溃疡患者中Hp的表型特征及其亚型，并评价Hp表型分型在十二指肠球部溃疡患者中的临床意义。方法用免疫印迹法检测135例十二指肠球部溃疡（研究组）及140例慢性浅表性胃炎（对照组）患者血清中细胞毒素相关蛋白A（CagA）抗体、空泡细胞毒素A（VacA）抗体和尿素酶（UreA、UreB）抗体及其亚型。结果研究组患者中，中间型Hp感染率为21．5％，明显低于对照组患者的27．9％，P〈0．05。VacA抗体和cagA抗体均可单独表达。Hp表型表达与Hp各亚型表达之间，CagA和VacA抗体在两组间比较差异无统计学意义，P〉0．05，但尿素酶抗体在研究组患者中的表达率明显高于对照组患者，P〈0．05。Ⅰ型Hp中尿素酶30ku亚基在研究组患者中的表达率（45．5％）亦明显高于对照组患者（33．3％），P〈b．05。结论cagA的表达不依赖于VaeA的表达。Hp多种亚型如128kuCagA、116kuCagA、95kuVacA、91kuVacA、30kuUreA同时表达在致十二指肠球部溃疡中起综合作用。Ⅰ型Hp且同时表达30kuUreA的菌株可能有更强的毒力且更易致十二指肠球部溃疡。Objective To study the characteristic typing of Helicobacter pylori （Hp）phenotypes and their sub-phenotypes in the patients with duodenal bulb ulcers （DU）,and its clinical significance. Methods One hundred thirty-five eases with DU and 140 eases with chronic superficial gastritis were enrolled in this study. Determinations of serum eytotoxin-associated gene protein A （CagA）, vacuolating cytotoxin A （VaeA）, urease （Ure）A,UreB antibodies and their sub-phenotypes by immunoblotting were carried out. Results Positive rate of middle-phenotypes of Hp infection in DU was significantly lower than that in chronic superficial gastritis （21.5% vs 27.9%,P 〈 0.05）. VacA and CagA antibodies might express alone. There had no significant difference among the expression rate of phenotype CagA, VaeA antibodies and their sub-phenotype. But expression rate of Ure antibodies in DU was higher than that in chronic superficial gastritis （P 〈 0.05 ）. In infection of Hp type I, the expression rate of sub-phenotypes 30 ku UreA in DU was higher than that in chronic superficial gastritis （P 〈 0.05）. Conclusions The VacA is not for expressing CagA. The expression of Hp exists many sub-phenotypes （128 ku CagA, 116 ku CagA, 95 ku VacA, 91 ku VacA, 30 ku UreA）,and it probably causes formation of DU by comprehensive effect. Hp type I with subphenotype expressing 30 ku UreA may be more pathogenic in DU formation.

关 键 词：螺杆菌 幽门 免疫印迹法 表型 细胞毒素相关基因蛋白 空泡毒素 

分 类 号：R573.1[医药卫生—消化系统] R457[医药卫生—内科学]