幽门螺杆菌血清免疫不同分型患者的胃粘膜不典型增生的发生情况  

INCIDENCE OF GASTRIC MUCOSA DYSPLASIA IN PATIENTS WITH DIFFERENT SERUM IMMUNOLOGICAL CLASSIFICATION OF HELICOBACTER PYLORI

作　　者：吕礁[1] 季兴英[1] 刘长云[1] 王石 施云星[1] 覃林花[1] 周国中[1] 

机构地区：[1]解放军第四一一医院消化内科,上海200081 [2]上海公利医院

出　　处：《解放军预防医学杂志》2013年第5期404-406,共3页Journal of Preventive Medicine of Chinese People's Liberation Army

摘　　要：目的探讨不同血清免疫类型幽门螺杆菌(H.pylori)感染对胃粘膜不典型增生的影响,以甄别与不典型增生有关的H.pylori免疫类型,从而为临床有目的选择病人进行抗H.pylori治疗及临床随访等提供依据。方法受检对象为289例。采用免疫印迹法检测血清中CagA、VacA等H.pylori抗体,并于电子胃镜下观察粘膜病变情况,以及活检粘膜标本经Giemsa染色及苏木精伊红(HE)染色后观察胃粘膜不典型增生情况,分析不同免疫类型H.pylori感染的胃粘膜不典型增生发生情况。结果 H.pylori抗体阳性者为186例,阳性率为64.4%。其中,CagA和VacA均阳性组与仅CagA阳性组胃粘膜不典型增生发生率分别为25.6%与20.2%,均显著高于CagA/VacA均阴性组的7.7%和仅CagA阴性组的9.8%,P均<0.05。结论不同免疫分型的胃粘膜不典型增生发生率不同。CagA和VacA均阳性组和仅CagA阳性组H.pylori感染者对胃粘膜不典型增生发生的影响更显著。应对这些免疫类型的H.pylori感染给予高度关注。Objective To study the effect of different classification of serum Helicobacter pylori （ H. pylo- ri） on gastric dysplasia, and to provide the basis for clinical treatment and follow-up study of H. pylori infection in accordance with its type. Methods A total of 289 inpatients and outpatients were examined. Gastric mucosa was taken for Helicobacter pylori test and pathological examination by biopsy under gastroscopy ; and serum H. pylori anti- bodies（ CagA, VacA） were detected by using Western blot method. Results One hundred and eighty-six patients showed positive H. pylori antibody. The incidence of gastric dysplasia in both CagA and VacA positive patients was significantly higher than that in both CagA and VacA negative patients （ 25.6% vs 7.7%, P〈0.05 ）. The inci- dence of gastric dysplasia in single CagA positive patients was also significantly higher than that in single CagA neg- ative patients （20.2% vs 9.8 %, P〈0.05 ）. Conclusions The incidence of gastric mucosa dysplasia in patients with different immunological classification of Helicobacter pylori infection is different. And the effect of both CagA and VaeA positive, or single CagA positive on gastric dysplasia was more marked than that of negative ones, so it should be paid close attention to the classification of H. pylori.

关 键 词：幽门螺杆菌 血清免疫分型 不典型增生 癌前病变 

分 类 号：R378.2[医药卫生—病原生物学]