不同证型慢性胃痛患者幽门螺杆菌基因型与胃上皮HLA-DR抗原表达的相关性  

Correlation of Helicobacter Pylori Genotypes of Chronic Stomachache Patients in Different TCM Syndromes with Gastric Epithelial HLA-DR Antigen Expression

作　　者：姜成[1] 林瑜[2] 王晓宁[1] 鄢春锦[1] 刘芬[1] 

机构地区：[1]福建中医药大学中西医结合学院 [2]福建中医药大学附属人民医院

出　　处：《中医杂志》2011年第24期2102-2105,2114,共5页Journal of Traditional Chinese Medicine

基　　金：福建省自然科学基金资助项目(2006J0355);福建中医药大学陈可冀中西医结合发展基金资助项目(CKJ2006005)

摘　　要：目的探讨幽门螺杆菌(Hp)细胞毒素相关基因(cagA)、空泡毒素基因(vacA)亚型与胃上皮人类白细胞抗原-DR(HLA-DR)抗原表达以及慢性胃痛中医证型之间的关系。方法将100例慢性胃炎或消化性溃疡患者中医辨证分为脾胃湿热证(57例)、肝气犯胃证(24例)和脾胃虚寒证(19例),采集各证型患者胃窦黏膜标本,采用特异引物PCR法检测vacA信号序列s和中间序列m亚型以及cagA基因;免疫组化方法分析胃上皮细胞HLA-DR抗原的表达。结果 100例患者中Hp感染率为81%,其中cagA基因检出率为44.4%(36/81),s1a基因检出率为90.1%(73/81),m2基因检出率为85.2%(69/81)。3种证型在Hp密度等级、cagA基因型及vacA基因亚型分布方面均无统计学差异(P>0.05);与阴性组比较,s1a+和m2+提高了HLA-DR抗原表达(P<0.01),cagA与HLA-DR抗原表达无关(P>0.05)。结论 Hp流行株以s1a或m2亚型为主,该流行株可提高胃上皮HLA-DR抗原的表达,但是vacA亚型、cagA基因与中医证型之间不存在相关性。Objective To explore the correlation between the helicobacter pylori （Hp） cytotoxin related gene cagA, vacuolo- toxin gene vacA subtype, and gastric epithelial HLA-DR antigen expression and the TCM syndromes of chronic stomachache. Methods One hundred cases of chronic gastritis or peptic ulcer were diagnosed with TCM syndrome differentiation, the spleen and stomach damp heat syndrome （57 cases）, liver qi attacking the stomach syndrome （24 cases）, and the spleen and stomach deficiency cold syndrome （19 cases）. The mucosal specimens were collected from the gastric antral region of all patients for de- tecting vacA signal sequence s and middle sequence m subtype and cagA gene with a specific primer PCR and analyzing the gas- tric epithelial HLA-DR antigen expression with an immunohistochemical method. Results Of the 100 cases, the Hp infection rate was 81%, the detectable rate of cagA gene was 44.4%（36/81）, the detectable rate of sla gene was 90.1%（73/81）, and the detectable rate of rn2 gene was 85.2% （69/81）. In the HP infection degree and the distribution of vacA genotype and cagA gene subtype, there wasn＇t statistical difference in the three TCM syndromes （P〉0.05）. Compared with negative group, the sla＋ and m2＋ improved the HLA-DR antigen expression （P〈0.01）, while the cagA was not correlated with the HLA-DR antigen expression （P〉0.05）. Conclusion The Hp epidemic strains are mainly of the sla or m2 subtypes, which could improve the gastric epithelial HLA-DR antigen expression, but the vacA subtype and cagA gene are not correlated with the different TCM syndromes.

关 键 词：幽门螺杆菌 细胞毒素相关基因 空泡毒素基因 人类白细胞抗原-DR 中医证型 

分 类 号：R259[医药卫生—中西医结合]