幽门螺杆菌抗体分型在诊治上消化道疾病中的意义  

Clinical significance of Helicobacter pylori and its related antibodies in the treatment and diagnosis of upper gastrointestinal disease

作　　者：江堤[1] 廖素环[1] 邓惠钊 唐潇 陈丽莉[3] 乐有林 苏剑东[1] 刘美红[1] Jiang Di;Liao Suhuan;Deng Huizhao(Dongguan Tung Wah Hospital,Dongguan,Guangdong 523000,China)

机构地区：[1]东莞东华医院消化内科 [2]东莞东华医院血液透析科 [3]东莞东华医院检验科,广东东莞523000

出　　处：《湘南学院学报（医学版）》2018年第3期29-32,共4页Journal of Xiangnan University（Medical Sciences）

基　　金：东莞市科技局一般项目(201750715046016)

摘　　要：目的通过检测上消化道疾病患者Hp阳性率及血清Hp抗体分型,了解其和上消化道疾病的关系。方法收集2017年3月1日~2018年6月1日我院明确诊断的上消化道疾病患者共400例,分为慢性浅表性胃炎组(CSG)、慢性萎缩性胃炎组(CAG)、消化性溃疡组(PU)、胃癌组(GC)、反流性食管炎组(RE)、功能性消化不良组(FD)。所有患者均行胃镜检查、检测Hp感染情况及抽取静脉血,采用免疫印迹法检测患者血清中Hp抗体分型,包括细胞毒素相关蛋白A(Cag A)、空泡毒素相关蛋白A(Vac A)、尿素酶A(UreA)、尿素酶B(UreB)。结果 400例患者中Hp总体感染率达78%,CSG、CAG、PU、GC、RE、FD组Hp感染率分别为76.5%、73.3%、85.7%、89%、71.4%和72.9%。GC及PU组Hp的感染率高于CSG组及CAG组(P<0.05)。GC组Cag A抗体及Vac A抗体阳性率高于其他各组(P<0.05)。PU组Cag A抗体及Vac A抗体阳性率高于CSG组(P> 0.05)。GC组UreA和UreB抗体均高于其他各组,其中和CSG组、CAG组、RE组及FD组比较差异有统计学意义(P<0.05),和PU组比较差异无统计学意义(P>0.05)。PU组UreA和UreB抗体高于除GC组外的其他组(P<0.05)。GC组Hp I型感染率显著高于CSG组、RE组、FD组(P<0.05),PU组、CAG组Hp I型感染率高于FD组(P<0.05)。结论随着胃黏膜病变的加重,Hp感染率及Hp I型的感染率有上升的趋势,Hp抗体分型可为上消化道疾病的临床诊治提供重要的实验室依据。Objective To investigate the relationship between Hp and upper gastrointestinal diseases by detecting the positive rate of Hp and Hp antibody typing in patients with upper gastrointestinal diseases.Methods 400 eligible patients with upper gastrointestinal disease in our hospital were selected as the subjects from March 2017 to July 2018. All patients were divided into chronic superficial gastritis（ CSG） group,chronic atrophic gastritis（ CAG） group,peptic ulcer（ PU） group,gastric cancer（ GC） group,reflux esophagitis（ RE） group and functional dyspepsia（ FD） group. All patients were underwent gastroscope examinations,detected Hp infection rate and extraction of venous blood. And the type of Hp antibody in patients＇ serum was detected by western blotting,including cytotoxic associated gene A（ CagA）,vacuolar toxin associated protein A（ VacA）,urease A（ UreA）,urease B（ UreB）. Results Total Hp infection rate in 400 patients were78%,and Hp infection rate in CSG,CAG,PU,GC,RE,FD group were 76.5%,73.3%,85.7%,89%,71.4%and 72.9%. The Hp infection rate of GC and PU group were higher than that of CSG and the CAG group（ P〈0.05）. The positive rate of VacA and CagA antibodies were higher than other groups（ P〈0.05）. The positive rate of CagA antibody and VacA antibody in PU group was higher than that in CSG group（ P〉0.05）.Both UreA and UreB antibodies in the GC group were higher than those in other groups. Compared with other groups,there were statistically significant differences between the GC group and the CSG group,the CAG group,the RE group and the FD group（ P〈0.05）,and no statistically significant differences between it and the PU group（ P〉0. 05）. Antibodies to UreA and UreB in the PU group were higher than those in other groups except the GC group（ P〈0.05）. HpI infection rate in GC group was significantly higher than that in CSG group,RE group and FD group（ P〈0. 05）,and Hp I infection rate in PU group and CAG group was higher than that in FD g

关 键 词：幽门螺杆菌 胃癌 空泡毒素相关蛋白A 细胞毒素相关蛋白A 

分 类 号：R57[医药卫生—消化系统]