基因芯片检测对H.pylori感染的诊断价值及H.pylori毒力因子与疾病组织病理的相关性  

Diagnostic value of gene chip test for detection of H.pylori infection and relationship between H.pylori virulence factors and the severity of gastroduodenal lesions

作　　者：任海涛[1,2] 徐樨巍[1] 李爱华[1] 

机构地区：[1]首都医科大学附属北京儿童医院,北京市100045 [2]航空工业中心医院,北京市100012

出　　处：《世界华人消化杂志》2010年第26期2826-2830,共5页World Chinese Journal of Digestology

摘　　要：目的:探讨基因芯片检测对幽门螺杆菌(H.pylori)感染的诊断价值及H.pylori致病毒力因子抗体与疾病病理严重程度的关系.方法:对2007-10/2008-04具有腹痛,呕吐,呕血,黑便等消化系统症状的30例患儿经13C呼气试验等方法进行H.pylori检测,对阳性的患儿做血清基因芯片检测,对基因芯片的检测方法进行敏感性、特异性分析;对两种方法均诊断H.pylori感染的病例行胃镜检查,观察镜下病变情况及组织病理改变,评估H.pylori毒力因子抗体与胃镜下表现及组织学严重程度的相关性.统计学分析采用诊断一致性分析Kappa检验.结果:血清学基因芯片毒力因子抗体检测与13C呼气试验等检测方法比较,敏感性为93.7%,特异性为60.0%,漏诊率为6.3%,总的符合率89.1%,显示较好的一致性.说明基因芯片检测对H.pylori感染的诊断具有一定的价值.H.pylori致病因子抗体谱中,抗CagA阳性的患者,对应的疾病有胃炎,消化性溃疡,过敏性紫癜腹型等.抗体谱最常见的是抗CagA阳性的表达,说明与抗原决定簇有关,而对应疾病病理较重时会有抗VacA阳性的表达.结论:基因芯片法检测H.pylori感染,具有特异性高,敏感性强的优点;同时能显示5种H.pylori毒力因子抗体,对了解H.pylori与疾病相关性、与疾病的严重程度关系及其指导用药均具有一定的意义.AIM： To investigate the diagnostic value of gene chip test for detection of Helicobacter pylori （H.pylori） infection in children, and to assess the relationship between H.pylori virulence factors and the severity of gastroduodenal lesions. METHODS： A total of 30 children with symptoms of the digestive system, such as abdominal pain, vomiting, melena and hematemesis, underwent the 13C breath test at Beijing Children’s Hospital from October 2007 to April 2008. A gene chip test was then performed for positive cases. The sensitivity and specificity of the gene chip test were analyzed. Gastroscopy was performed in patients diagnosed with H.pylori infection by both of the above methods. The pathologicalchanges in gastroduodenal lesions were examined by gastroscopy to assess the relationship between H.pylori virulence factors and the severity of H.pylori. The results were analyzed by the Kappa test. RESULTS： The gene chip test has a sensitivity of 93.7%, a specificity of 60%, and a rate of missed diagnosis of 6.3%. The coincidence rate between the 13C breath test and gene chip test is 89.1%, showing a good consistency. H.pylori CagA antibody was detected in 96.6% （29/30） of the patients, while the detection rate of VacA antibody is 3.3%. H.pylori carrying CagA may have a stronger pathogenicity. The presence of CagA antibody was often related with gastritis, peptic ulcer and Henoch-Schonlein syndrome （abdominal type）, while the presence of VacA antibody predicted more severe pathological manifestations. CONCLUSION： The gene chip test has a high specificity and sensitivity in detection of H.pylori infection, and is useful for finding the relationship between H.pylori virulence factors and the severity of disease.

关 键 词：幽门螺杆菌 基因芯片 毒力因子 抗体谱 

分 类 号：R57[医药卫生—消化系统]