幽门螺旋杆菌阳性慢性萎缩性胃炎患者血清CagA抗体浓度评估黏膜病变程度的价值  

The value of serum CagA antibody quantitative determination in patients with H. pylori positive chronical atrophic gastritis for assessing the degree of mucosal lesion

作　　者：奚经巧[1] 林枝[1] 陈建欧[2] 李丽燕[2] 郑伟伟[3] 蔡文品[1] XI Jing-qiao;LIN Zhi;CHEN Jian-ou;LI Li-yan;ZHENG Wei-wei;CAI Wen-pin(Clinical Laboratory,Wenzhou Hospital of Traditional Chinese Medicine,Wenzhou,Zhejiang 325000,China)

机构地区：[1]温州市中医院检验科,浙江温州325000 [2]温州市中医院病理科,浙江温州325000 [3]温州市中医院消化内科,浙江温州325000

出　　处：《中国卫生检验杂志》2018年第17期2128-2131,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的分析细胞毒素相关蛋白A(cytotoxinassociatedgeneA,CagA)抗体阳性患者胃黏膜不同程度病理病变时CagA抗体水平的差异与相关性,明确CagA抗体浓度评估胃黏膜病变的价值。方法选取HP感染阳性的CAG179例,ELISA法检测血清CagA抗体、胃蛋白酶原Ⅰ(PGⅠ)与Ⅱ(PGⅡ)并计算PGR值,胃黏膜病变程度评价病理参数包括炎性反应、活动性、萎缩、肠化生。分析CagA抗体阳性组和阴性组PGⅠ、PGⅡ、PGR差异,同时比较黏膜各病理参数不同程度间CagA抗体浓度的差异性及相关性。结果179例慢性萎缩性胃炎患者中CagA抗体阳性138例,阳性率为72.25%(138/179)。CagA抗体阳性CAG患者血清胃蛋白酶原Ⅰ与Ⅱ高于阴性患者(P<0.05)。与CagA抗体阴性患者比较,CagA抗体阳性CAG患者胃黏膜萎缩和肠化生病变程度明显加重(P<0.05)。血清CagA水平与黏膜萎缩程度及肠化生程度间呈正相关(相关系数分别为0.365、0.302,P<0.05)。结论HP阳性的CAG患者血清CagA抗体表达与萎缩性胃炎病情进展密切相关,高浓度血清CagA抗体表示黏膜病变的加重,监测CagA抗体有助于病情的评估。Objective To analyze the difference and correlation of Cag A antibody levels in gastric mucosa with different degrees of pathological changes in Cag A antibody positive patients,and to determine the value of Cag A antibody concentration in the evaluation of gastric mucosal lesions. Methods 179 H. pylori positive patients with chronic atrophic gastritis were included.Serum Cag A antibody titer,pepsinogen（ PG） Ⅰ and PGⅡ were detected by enzyme linked inmmunoabsorbent assay（ ELISA）.Furthermore,the pathological changes of the gastric mucosa included inflammatory response,activity,atrophy and intestinal metaphase. The differences of PGⅠ,PGⅡ,PGR and mucosal pathological parameters in Cag A-positive group and Cag A-negative group were statistically analyzed. Meanwhile,the difference of Cag A antibody concentration between different pathological parameters of mucosa was compared. Results Among 179 patients with chronic atrophic gastritis,138 patients were positive for Cag A antibody,and the positive rate was 72. 25%（ 138/179）. Serum pepsinogen Ⅰ and Ⅱ were higher in Cag A antibody-positive CAG patients than that in negative patients（ P〈 0. 05）. Compared with Cag A antibody-negative patients,gastric mucosal atrophy and intestinal metaplasia were significantly aggravated in Cag A-positive CAG patients（ P 〈0. 05）.There was a positive correlation between serum Cag A level and degree of mucosal atrophy and intestinal metaplasia（ correlation coefficients were 0. 365,0. 302,P〈 0. 05）. Conclusion The results suggest that H. pylori with Cag A protein may contribute to chronic atrophic gastritis. Higher serum Cag A antibody can indicate the aggravation of mucosal lesions. Therefore,monitoring Cag A antibodies is helpful in assessing the disease degrees.

关 键 词：幽门螺旋杆菌 细胞毒素蛋白A抗体 慢性萎缩性胃炎 胃蛋白酶原 

分 类 号：R573.32[医药卫生—消化系统]