慢性乙型肝炎病毒感染患者血清及肝组织中抗幽门螺杆菌抗体及特异性基因分析  

Seroprevalence of antibody against Helicobacter pylori and identification of its specific genes in liver tissues of chronic hepatitis B virus infected patients

作　　者：季尚玮[1] 王江滨[1] 张永贵[1] 

机构地区：[1]吉林大学中日联谊医院消化科,吉林省消化系疾病重点实验室,130033

出　　处：《中华消化杂志》2009年第8期505-509,共5页Chinese Journal of Digestion

基　　金：国家自然科学基金资助项目（30670300）

摘　　要：目的对慢性乙型肝炎病毒（HBV）感染患者血清抗幽门螺杆菌（Hp）IgG（抗HpIgG）阳性率进行流行病学调查，同时对患者肝组织进行Hp特异性基因检测，探讨Hp在肝病发生、发展中的作用。方法病例对照研究中共纳入502例HBV感染患者和性别、年龄相匹配的429名健康对照者。应用酶联免疫吸附（EusA）法进行血清抗Hp—IgG检测。同时用针对螺杆菌菌属特异性16SrRNA基因的通用引物对其中56例肝穿刺活检组织进行基因扩增，并对该基因阳性者进一步应用HpcagA、vacA和glmM基因特异引物进行扩增。结果HBV感染患者血清抗HpqgG阳性率为63．9％，显著高于健康对照者（43．4％，P〈0．05），其中肝癌组的阳性率最高（29／36，80．6％），其次为肝硬化组（64／83，77．1％），两组均显著高于慢性乙型肝炎组（228／383，59．5％，P〈0．01）。56例行肝穿刺活检患者中，35例肝组织中发现螺杆菌菌属特异性16SrRNA基因，其中肝硬化组17例，肝癌组7例，慢性乙型肝炎组11例。进一步的扩增结果证实35例中21例为HpDNA。结论HBV感染患者血清抗Hp-IgG阳性率显著高于健康对照者。HBV感染患者肝组织中除存在HpDNA外，可能还存在其他螺杆菌DNA。螺杆菌在慢性乙型肝炎向肝硬化和肝癌的发展过程中可能发挥致病作用。Objective To analyze the seroprevalence of Helicobacter pylori （H. pylori） infection and its specific genes in liver tissues of chronic hepatitis B virus （HBV） infected patients, and to investigate the effect of H. pylori on development of chronic HBV infected liver diseases. Methods Five hundred and two patients infected with HBV and 429 sex-and age matched healthy controls were enrolled in the case-control study. All subjects were tested for presence of antibodies against H. pylori using ELISA. Fifty-six liver biopsy samples were amplified by polymerase chain reaction （PCR） using Helicobacter genus-specific 16S rRNA primers. The positive samples were further amplified using specific primers of H. pylori cagA, vacA and glmM genes. Results H. pylori infection was accounted for 63. 9% in HBV infected patients, which was higher than that in healthy controls （43.4%, P〈 0.05）. Moreover, the seroprevalence of H. pylori in patients with hepatocellular carcinoma （HCC, 29/36,80.6%） or cirrhosis （64/83,77. 1%） was higher than that in patients with chronic hepatitis （228/383,59. 5%, P〈0.01）. Helicobacter genus-specific 16S rRNA was found in 17,7 or 11 of patients with cirrhosis, HCC or chronic hepatitis. Twenty-one samples were confirmed as H. pylori DNA by PCR. Conclusions The seroprevalenee of antibody against H. pylori was higher in HBV infected patients compared with healthy controls. Besides H. pylori, other Helicobacter can be detected in liver tissues of HBV infected patients. H. pylori might play the role in the development of chronic hepatitis to cirrhosis and HCC.

关 键 词：螺杆菌 幽门 肝炎 乙型 肝硬化 肝肿瘤 

分 类 号：R686[医药卫生—骨科学]