幽门螺杆菌感染抗体分型与慢性胃炎严重程度及黏膜组织学变化之间的关系  

Relationship between antibody typing of Helicobacter pylori infection and severity of chronic gastritis and mucosal histological changes

作　　者：张宁 赵甘婷[1] ZHANG Ning;ZHAO Ganting(Department of Gastroenterology,Heping Hospital Affiliated to Changzhi Medical College,Changzhi 046000,China)

机构地区：[1]长治医学院附属和平医院消化内科,山西长治046000

出　　处：《胃肠病学和肝病学杂志》2024年第8期966-973,共8页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的 探究H.pylori感染抗体分型与慢性胃炎严重程度及黏膜组织学变化之间的关系。方法 选取2019年1月至2022年4月于我院就诊的507例慢性胃炎患者作为研究对象。根据慢性胃炎严重程度分为轻度组(n=205)、中度组(n=180)和重度组(n=122)。通过倾向性评分匹配(propensity score matching, PSM)法按照1∶1∶1匹配后三组各为100例,比较三组患者的一般资料、影响重度慢性胃炎发生的临床指标以及慢性胃炎严重程度及黏膜组织学变化与H.pylori抗体分型的相关性分析。多因素Logistic回归分析影响重度慢性胃炎发生的危险因素,并构建影响因素的结构方程模型,进行结构方程模型变量的效应分析。Spearman相关性检验分析慢性胃炎严重程度及黏膜组织学变化与H.pylori抗体分型之间的相关性。结果 H.pylori抗体分型、胃黏膜病变、肠化程度、萎缩程度均为影响重度慢性胃炎发生的独立危险因素(P<0.05)。构建的结构方程模型整体适配情况较好,能很好地反映各影响因素与重度慢性胃炎发生的关系。慢性胃炎严重程度及胃黏膜萎缩程度与H.pyloriⅠ型感染呈显著正相关(P<0.05),H.pylori抗体阴性与慢性胃炎严重程度及胃黏膜萎缩程度呈显著负相关(P<0.05)。结论 H.pylori感染抗体分型在慢性胃炎严重程度及胃黏膜萎缩程度中具有较高的临床应用价值,且与慢性胃炎患者的严重程度及胃黏膜组织学变化关系密切。Objective To investigate the relationship between Helicobacter pylori(H.pylori)infection antibody typing and the severity of chronic gastritis and mucosal histological changes.Methods A total of 507 chronic gastritis patients treated in our hospital from Jan.2019 to Apr.2022 were selected as study objects.According to the severity of chronic gastritis,the patients were divided into mild group(n=205),moderate group(n=180)and severe group(n=122).After 1∶1∶1 propensity score matching(PSM),100 patients were selected from each group to compare the general data,clinical indicators affecting the occurrence of severe chronic gastritis,the correlation analysis between the severity of chronic gastritis and the change of mucosal histology and the typing of H.pylori antibody in the three groups.Multivariate Logistic regression analysis was used to identify risk factors affecting the occurrence of severe chronic gastritis.A structural equation model was constructed to analyze the effects of influencing factors.Spearman correlation test was used to analyze the correlation between chronic gastritis severity and mucosal histological changes and H.pylori antibody typing.Results H.pylori antibody typing,gastric mucosal lesions,degree of intestinal metaplasia and gastric mucosa atrophy were all independent risk factors affecting the occurrence of severe chronic gastritis(P<0.05).The structural equation model was well adapted and could reflect the relationship between various factors and the occurrence of severe chronic gastritis.The severity of chronic gastritis and the degree of gastric mucosa atrophy were significantly positively correlated with H.pylori-Ⅰinfection(P<0.05),while the negative H.pylori antibody was significantly negatively correlated with the severity of chronic gastritis and the degree of gastric mucosa atrophy(P<0.05).Conclusion H.pylori infection antibody typing has high clinical application value in the severity of chronic gastritis and the degree of gastric mucosa atrophy,and is closely related to the se

关 键 词：幽门螺杆菌 抗体 慢性胃炎 胃黏膜损伤 

分 类 号：R378[医药卫生—病原生物学] R573[医药卫生—基础医学]