幽门螺杆菌抗体分型检测及分型与胃部疾病的相关性分析  

The Detection of Helicobacter Pylori Antibody Typing and Analysis of Correlation Between Typing and Gastric Disease

作　　者：张苗苗 赵志鹏[1] 李晓晨 金一珺 任渝堂 姜泊 蒋绚 赵秀英[1] ZHANG Miaomiao;ZHAO Zhipeng;LI Xiaochen;JIN Yijun;REN Yutang;JIANG Bo;JIANG Xuan;ZHAO Xiuying(Department of Clinical Laboratory,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China;Department of Gastroenterology,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China)

机构地区：[1]清华大学附属北京清华长庚医院,清华大学临床医学院检验科,北京102218 [2]清华大学附属北京清华长庚医院,清华大学临床医学院消化科,北京102218

出　　处：《标记免疫分析与临床》2020年第8期1305-1309,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的通过免疫印迹法(WB)检测慢性胃炎患者幽门螺杆菌(Hp)抗体及分型,结合胃镜及病理结果分析感染I型与II型Hp与胃部疾病的相关性。方法选取2016年8月至2018年3月在北京清华长庚医院消化科就诊的慢性胃炎患者共504例,其中男性247例,女性257例,年龄分布为19~80岁。所有患者采用WB法进行Hp抗体分型,其中168例同时行13C呼气试验,249例同时行胃镜检查,胃镜检查者中有93例行病理诊断及Hp特殊染色。结果504例患者中Hp抗体阳性率达57.9%;不同性别之间I型与II型Hp感染率无明显差异,但不同年龄组之间I型与II型感染率有统计学差异(χ^2=9.89,P<0.05),小于30岁人群I型感染率最低;将抗体分型结果与13C呼气试验、Hp特殊染色进行一致性比较,前者中度一致,后者一致性差;249例胃镜检查患者中,感染I型例数为79例(31.7%),II型例数为67例(26.9%);其中诊断胃黏膜糜烂、溃疡及萎缩性胃炎者Hp感染率明显高于普通胃炎患者(χ^2=8.49,P<0.05),诊断萎缩性胃炎/不典型增生组I型感染率明显高于II型(χ^2=6.32,P<0.01)。结论感染I型Hp既毒力株者可导致较明显的胃部疾病,应用WB法对Hp抗体分型有助于指导慢性胃病的临床诊疗。Objective To evaluate the correlation of helicobacter pylori(Hp)typing,such as infected by type I or type II Hp on disease progression of chronic gastritis(CG).Methods A total of 504 patients,presented to the Department of Gastroenterology in Tsinghua Changgung Hospital and diagnosed with CG from August,2016 to March,2018,with 247 males and 257 females and the age distribution was from 19 to 80 years old,were included for the study.All the patients were tested with the serum antibodies to Hp by western blot(WB)and hence were sub-typed into Type I and Type II.Among them,168 patients underwent 13C breath test simultaneously,249 patients underwent gastroscopy at the same time,and 93 patients were taken gastric mucosa for pathology assay and special staining of Hp.Results The general positive rate of serum antibody to Hp was 57.9%in the whole cohort.There was no significant difference in the infection rate of type I and type II Hp among different genders,while there was a significant difference among age groups(χ^2=9.89 P<0.05),in which patients younger than 30 years old had the lowest infection rate of type I Hp.The antibody typing results were moderately consistent with 13C breath test,and poorly consistent with special staining.In 249 cases with gastroscope diagnosis,79(31.7%)were identified with type I and 67(26.9%)with type II.However,the infection rate of Hp was relatively high in patients with severe disease(χ^2=8.49 P<0.05),and the type I infection was significantly increased in patients with chronic atrophic gastritis or dysplasia(χ^2=6.32 P<0.01).Conclusion Infection with a virulent strain of type I Hp can lead to a severe gastric disease,and WB based antibody typing assay is helpful to the clinical diagnosis and trea.

关 键 词：幽门螺杆菌 分型 慢性胃炎 胃镜检查 

分 类 号：R378.99[医药卫生—病原生物学]