幽门螺杆菌感染患儿血细胞毒素相关性基因A、空泡毒素蛋白、尿毒酶、热休克蛋白60和硝基还原酶的分布及其诊断价值  

Distributions of Cytotoxin-Associated Gene A,VacA Associated Protein,Urease,Heat Shock Protein 60 and Resistance to Metronidazole Nitro-Reductase A in Blood of Children with Helicobacter Pylori Infection and Their Diagnostic Value

作　　者：任海涛[1] 徐樨巍[2] 李爱华[2] 

机构地区：[1]首都医科大学附属北京儿童医院儿内科,北京100045 [2]首都医科大学附属北京儿童医院血清室,北京100045

出　　处：《实用儿科临床杂志》2012年第13期1009-1011,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨基因芯片检测幽门螺杆菌(Hp)感染患儿血细胞毒素相关基因A(CagA)、空泡毒素蛋白(VacA)、尿毒酶(Ure)、热休克蛋白60(Hsp60)和硝基还原酶(RdxA)等毒力因子分布情况及胃镜下组织学表现。方法选取2007年10月-2008年5月在本院住院,具有腹痛、呕吐、呕血、黑便等消化系统症状,经2种及2种以上方法确诊为Hp感染的患儿30例。经胃镜诊断分为胃炎组(n=23)和消化性溃疡组(n=7),观察相应的CagA、VacA、Ure、Hsp60和RdxA等毒力因子抗体在不同疾病的分布情况;同时观察其胃镜下胃组织学表现,评估Hp毒力因子抗体与胃镜下表现及相关疾病的关系。比较CagA在胃炎组和消化性溃疡组的分布情况,应用SPSS 17.0软件进行统计学处理。结果 30例Hp感染患儿的致病毒力因子分布情况:CagA阳性29例(占96.7%)、Ure阳性14例(占46.7%)、RdxA阳性7例(占23.3%)、Hsp60 3例(占10.0%)和VacA阳性1例(占3.3%)。消化性溃疡组CagA阳性率(100%)高于胃炎组CagA阳性率(95.7%),但差异无统计学意义(χ2=1.000,P>0.05)。胃镜下胃炎组表现为黏膜充血、水肿、点片状出血斑、颗粒样变性、花斑样变性,消化性溃疡组表现为溃疡、黏膜充血水肿、出血样变,有时伴有食管胃底静脉曲张。抗CagA阳性患儿对应黏膜改变最为广泛。结论 Hp感染与CagA、VacA、Ure、Hsp60和RdxA等毒力因子相关,与CagA关系最为密切,VacA与疾病的严重程度相关。CagA阳性能够增加细胞毒素的活性,但其结果并不能预示疾病发展为胃炎或者消化性溃疡。Objective To investigate the gene chip detection for helicobacter priori（Hp） infection in the sick children and the distribu- tion of cytotoxin - associated cytotoxin - associated gene A （ CagA）, VacA, urease （ Ure）, heat shock protein 60 （ Hsp60 ） and resistance to met- ronidazole nitro -reductase A（RdxA） and observe the gastroscopic manifestations. Methods Thirty hospitalized patients in Beijing Children＇s Hospital Affiliated to Capital Medical University, from Oct. 2007 to May 2008 were selected, who had abdominal pain, vomiting, hematemesis, melena and other gastrointestinal symptoms, confirmed as Hp infection by 2 or more clinical examinations. The patients were divided into the gastritis group and the peptic ulcer group by gastroscopic diagnosis, and the corresponding CagA, VacA, Ure, Hsp60 and RdxA virulent factors such as antibodies were observed for the distribution in different diseases. Meanwhile,the histological features of gastroscopy were observed to assess the virulent factors for Hp antibodies and gastroscopic and histological severity. The distribution of CagA in gastritis and peptic ulcer group was compared. SPSS 17.0 software was used to analyzed the data. Results Thirty cases of children with Hp infection caused by viruses force factor distribution：CagA was positive in 29 cases （96.7%） ,Ure was positive in 14 cases （46.7%） ,RdxA was positive in 7 cases （23.3%） ,Hsp60 was positive in 3 cases （10.0%） and VacA was positive in 1 case（3.3% ）. CagA -positive rate in peptic ulcer group （ 100% ） was higher than that in chronic gastritis group （ 95.7% ）, but the difference was not significant （X2 = 1. 000, P 〉 0.05 ）. Gastritis group showed mucosal congestion, edema,point sheet bleeding spots, granular degeneration, piebald degeneration. Peptic ulcer group showed ulcers, mucosal congestion and edema, hemorrhage - like changes, sometimes accompanied by esophageal varices. The patients whose anti - CagA were positive had mucosal changes most widel

关 键 词：幽门螺杆菌 毒力因子 抗体谱 慢性胃炎 消化性溃疡 

分 类 号：R725.7[医药卫生—儿科]