幽门螺杆菌CagA基因和消化道疾病的关系研究  

Study on the correlation between CagA gene of Helicobacter pylori and gastrointestinal diseases

作　　者：叶东雯 YE Dong-wen(Department Five of Internal Medicine,Guangzhou Xinhai Hospital,Guangzhou 510300,China)

机构地区：[1]广州新海医院内五科,510300

出　　处：《中国现代药物应用》2020年第12期4-6,共3页Chinese Journal of Modern Drug Application

摘　　要：目的讨论幽门螺杆菌(Hp)CagA基因和消化道疾病之间的关系。方法163例消化道疾病患者作为研究对象,将患者的胃黏膜作为标本进行Hp培养分离并实施聚合酶链式反应(PCR),对Hp的毒力基因型CagA进行检测,并分析其与消化道疾病之间的关系。结果163例消化道疾病患者的胃黏膜标本中分离出Hp菌株43株,阳性率为26.38%。CagA基因在消化性溃疡中的阳性率为83.33%(15/18),在浅表性胃炎中的阳性率为50.00%(3/6),在萎缩性胃炎中的阳性率为75.00%(3/4),在胃癌中的阳性率为93.33%(14/15)。胃癌的CagA基因阳性率高于浅表性胃炎,差异具有统计学意义(P<0.05);消化性溃疡、萎缩性胃炎与浅表性胃炎的CagA基因阳性率比较,差异无统计学意义(P>0.05)。Hp CagA阳性慢性胃炎患者的中、重度急性活动性胃炎发生率为76.67%,高于CagA阴性慢性胃炎患者的31.82%,差异具有统计学意义(P<0.05);Hp CagA阳性慢性胃炎患者的肠上皮化生发生率为53.33%,与CagA阴性慢性胃炎患者的36.36%比较,差异无统计学意义(P>0.05)。结论Hp的毒力因子CagA与消化道疾病的发生有着密切的关系,且以胃癌最为明显,且在Hp CagA阳性感染患者中发生中、重度急性活动性胃炎的几率较高,临床需对其提高警惕。Objective To discuss the correlation between cagA gene of Helicobacter pylori(Hp)and gastrointestinal diseases.Methods A total of 163 patients with gastrointestinal disease were taken as study subjects.The patient’s gastric mucosa was used as a specimen for Hp culture separation,and polymerase chain reaction(PCR)was performed to detect the virulence genotype CagA of Hp and analyze its correlation with gastrointestinal diseases.Results 43 Hp strains were isolated from gastric mucosa specimens of 163 patients with gastrointestinal diseases,and the positive rate was 26.38%.The positive rate of CagA gene was 83.33%(15/18)in peptic ulcer,50.00%(3/6)in superficial gastritis,75.00%(3/4)in atrophic gastritis and 93.33%(14/15)in gastric cancer.The positive rate of CagA gene in gastric cancer was higher than that in superficial gastritis,and the difference was statistically significant(P<0.05).There was no statistically significant difference in positive rate of CagA gene in peptic ulcer,atrophic gastritis and superficial gastritis(P>0.05).The incidence of moderate and severe acute active gastritis of Hp CagA positive patients with chronic gastritis was 76.67%,which was higher than that of Hp CagA negative patients with chronic gastritis 31.82%,and the difference was statistically significant(P<0.05).The incidence of intestinal metaplasia of Hp CagA positive patients with chronic gastritis was 53.33%,which had no statistically significant difference compared with that of Hp CagA negative patients with chronic gastritis 36.36%(P>0.05).Conclusion CagA,the virulence factor of Hp,is closely correlated to the occurrence of gastrointestinal diseases,and gastric cancer is the most obvious one,and the probability of moderate to severe acute active gastritis in patients with Hp CagA-positive infection is higher,which should be paid more attention to in clinic.

关 键 词：幽门螺杆菌 CAGA基因 消化道疾病 

分 类 号：R57[医药卫生—消化系统]