幽门螺杆菌毒力基因cagA、vacA、iceA表达与慢性萎缩性胃炎的关系  

Relationship between expression of virulence genes cagA, vacA and iceA in Helicobacter pylori and chronic atrophic gastritis

作　　者：蔡加锭 苏海水 洪清楚 邹秀卿 CAI Jia-ding;SU Hai-shui;HONG Qing-chu;ZOU Xiu-qing(Xiamen Fifth Hospital,Xiamen,Fujian 36110l,China)

机构地区：[1]厦门市第五医院消化内科,福建厦门361101 [2]厦门市第五医院检验科,福建厦门361101 [3]厦门市第五医院体检中心,福建厦门361101

出　　处：《中华医院感染学杂志》2023年第1期27-30,共4页Chinese Journal of Nosocomiology

基　　金：福建省自然科学基金资助项目(2020J01297)。

摘　　要：目的 探讨幽门螺旋杆菌(Hp)毒力基因cagA、vacA、iceA表达与慢性萎缩性胃炎(CAG)的关系。方法 选取2018年6月-2021年6月厦门市第五医院收治的CAG患者190例,采用聚合酶链式反应(PCR)检测毒力基因cagA、vacA、iceA表达情况,根据毒力基因表达情况分为对照组(无毒力基因表达)18例、A组(一种毒力基因表达)67例、B组(两种毒力基因表达)58例和C组(3种毒力基因表达)47例。比较各组慢性胃炎分级评估系统(OLGA)分级、合并化生、上皮内瘤变和血清胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、胃泌素(GAS)水平。结果 不同毒力基因表达患者OLGA分级、化生和上皮内瘤变情况比较,差异有统计学意义(P<0.05),且A、B、C组OLGA分级Ⅲ~Ⅳ级、合并化生和上皮内瘤变的占比均高于对照组(P<0.05),C组的OLGA分级Ⅲ~Ⅳ级、合并化生和上皮内瘤变的占比高于A、B组(P<0.05),但A和B组比较,差异无统计学意义;各组患者血清PGⅠ、PGⅡ和GAS水平比较,差异有统计学意义(P<0.05);且对照组>A组>B组>C组(P<0.05)。结论 Hp毒力基因cagA、vacA、iceA表达可能与CAG患者病情发生发展及病情严重程度有关,3种基因同时表达更容易加重CAG病情。OBJECTIVE To explore the relationship between the expression of virulence genes cagA, vacA and iceA in Helicobacter pylori and the chronic atrophic gastritis(CAG). METHODS Totally 190 patients with CAG who were treated in Xiamen Fifth Hospital from Jun 2018 to Jun 2021 were enrolled in the study. The expressions of virulence genes cagA, vacA and iceA were detected by polymerase chain reaction(PCR). The enrolled patients were divided into the control group with 18 cases( without expression of virulence genes), the group A with 67 cases(with expression of one virulence gene), the group B with 58 cases(with expression of two virulence genes) and the group C with 47 cases(with expression of three virulence genes) according to the expression of virulence genes. The Operative Link on Gastritis Assessment(OLGA) grading, intestinal metaplasia, intraepithelial neoplasia, serum pepsinogen Ⅰ(PG Ⅰ) level, pepsinogen Ⅱ(PG Ⅱ) level and gastrin(GAS) level were observed and compared among the four groups. RESULTS There were significant differences in the OLGA grade, intestinal metaplasia and intraepithelial neoplasia among the patients with different expressions of virulence genes(P<0.05);the proportions of the patients with OLGA grade ranging between Ⅲ and Ⅳ, intestinal metaplasia and intraepithelial neoplasia were higher in the group A, B and C than in the control group(P<0.05);the proportions of the patients with OLGA grade ranging between Ⅲ and Ⅳ, intestinal metaplasia and intraepithelial neoplasia were higher in the group C than in the group A and B(P<0.05);however, there were no significant differences between the group A and the group B. There were significant differences in the levels of serum PGⅠ, PGⅡ and GAS among the four groups(P<0.05);the levels of above indexes, from high to low, were as follows: the control group, the group A, the group B, the group C. CONCLUSION The expression of virulence genes cagA, vacA and iceA in H. pylori may be associated with the genesis, progression and severity of CA

关 键 词：慢性萎缩性胃炎 幽门螺杆菌 毒力基因 基因表达 胃蛋白酶原 胃泌素 

分 类 号：R573.32[医药卫生—消化系统]