幽门螺杆菌毒素与儿童胃十二指肠疾病关系的研究  

Association of Helicobacter pylori toxin antibody with gastroduodenal disease in children

作　　者：张英[1] 陈洁[1] 汤宏峰[1] 陈肖肖[1] 吴秀英[1] 陈黎勤[1] 章许平[1] 欧弼悠[1] 

机构地区：[1]浙江大学医学院附属儿童医院消化科

出　　处：《中华儿科杂志》2001年第8期473-476,共4页Chinese Journal of Pediatrics

摘　　要：目的　探讨幽门螺杆菌 (Hp)毒素与儿童胃十二指肠疾病的关系及Hp毒素参与胃十二指肠粘膜病变的机制 ,并评价Hp毒素抗体检测的临床意义。方法　采用免疫印迹法测定 39例Hp阳性和 32例Hp阴性患儿血清多种Hp毒素抗体。观察胃十二指肠粘膜病理变化。结果　Hp阳性患儿 ,Hp毒素抗体相对分子质量为 116 0 0 0、30 0 0 0、2 6 5 0 0、195 0 0和现症感染标志 (CIM)的阳性率均为10 0 %。相对分子质量为 890 0 0、6 10 0 0、5 80 0 0、370 0 0和 35 0 0 0的阳性率分别为 94 9%、87 2 %、5 3 9%、87 2 %和 46 2 %。HpⅠ型菌株占 94 9% ,未检出Ⅱ型菌株。Hp阴性患儿各抗体的检出率为0 %～ 2 8 1%。各种抗体在不同疾病之间的检出率无显著差异。细胞毒素相关蛋白 (CagA)、空泡细胞毒素 (VacA)和尿素酶A、D、E抗体阳性者胃十二指肠粘膜无一例正常 ,中重度炎症发生率为 94 9%～97 3%。尿素酶B抗体阳性者胃粘膜中性粒细胞浸润比阴性者多见 ,差异有显著性。结论　本地区儿童主要感染HpⅠ型毒力菌株 ,引起的胃十二指肠粘膜炎症较严重。尿素酶B抗体阳性提示胃粘膜有活动性炎症。CagA。Objective To study the relationship between Helicobacter pylori(Hp) toxin and gastroduodenal disease in children,and to explore the effect of Hp toxin on lesion of gastroduodenal mucous membrane,and to evaluate clinical significance of Hp toxin antibody. Methods The children were divided into 2 groups : Hp positive group, 39 children, agde 3～16 years and Hp negative group, 32 children, agde 3～14 years, who presented upper gastrointestinal symptoms and underwent electronic gastroscopy. The children′s serum 116000(Cytotoxin Associated Protein,CagA),89000 (Vaocuolating Cytotoxin , VacA), 61000(Urease B), 58000(B subunit of VacA),37 000(A subunit of VacA), 35000(Cell Binding factor), 30000(Urease A),26 500(Urease D),19500(Urease E) antibody and current infection marker (CIM) Hp toxin antibody were measured by Western blot (Helico blot 2.1 , Genelabs Diagnostics) in all children. The gastric and duodenal biopsy specimens of all children were studied histologically. Results The detection rate of 116 000, 30 000,26 500,19 500 and CIM was 100% and one of 89 000,61 000,58 000,37 000 and 35 000 was 94.9%,87.2%,53.9%,87.2% and 46.2% respectively in Hp positive group. The detection rate of the antibodies was 0%～28.1% in Hp negative group. Hp type Ⅰstrains accounted for 94.9%, without Hp type Ⅱstrains. There was no significant difference in the detection rate of antibody among gastritis,duodenitis and duodenal ulcer. None of the children with antibodies against CagA, VacA, Urease A, Urease D and Urease E had normal gastroduodenal mucous membrance and the detection rate of gastroduodenal mucosal moderate severe inflammation was 94.9% to 97.3%. Histologically,the degree of gastric mucosal neutrophil infiltration in children with urease B antibodies were more severe than that in those who were negative for the antibodies ( P <0.05). Conclusions Children in our region infected with mainly Hp type Ⅰ strains. Urease B antibody may be one of the markers of gastric mucosa active inflammation.CagA,VacA,urease A

关 键 词：螺杆菌 胃疾病 十二指肠疾病 细胞毒素类 抗体 儿童 CIM检测 Hp毒素 

分 类 号：R725.7[医药卫生—儿科]