不同毒力幽门螺杆菌感染与结直肠息肉的相关性分析  

Correlation analysis between Helicobacter pylori infection with different virulence and colorectal polyps

作　　者：邹荣[1] 方向明[1] ZOU Rong;FANG Xiang-ming

机构地区：[1]武汉科技大学附属普仁医院消化内科,湖北武汉430081

出　　处：《临床消化病杂志》2024年第5期333-337,共5页Chinese Journal of Clinical Gastroenterology

基　　金：武汉市临床医学科研项目面上项目(WX20 C14)。

摘　　要：[目的]探讨不同毒力幽门螺杆菌(Helicobacter pylori,Hp)感染与结直肠息肉发生的相关性。[方法]按入选标准和排除条件筛选出400例患者作为研究对象。由~(13)C或~(14)C尿素呼气试验诊断为Hp感染患者行Hp血清抗体检测,并将抗体阳性者分为HpⅠ型抗体组(Ⅰ型组)和HpⅡ型抗体组(Ⅱ型组),比较不同毒力Hp感染与结直肠息肉相关性。最后根据Hp表达细胞毒素相关基因A(Cytotoxin Associated Gene A,CagA)和空泡变性细胞毒素A(Vacuolation Toxin A,VacA)的差异,将Hp血清抗体阳性者分为CagA+VacA组、仅含CagA组和仅含VacA组,比较各组间结直肠息肉的临床特征差异。[结果]Ⅰ型组息肉检出率高于Ⅱ型组(94.5%比44.1%,P<0.05),Ⅰ型组息肉在左半结肠的检出率高于Ⅱ型组(51.8%比11.9%,P<0.05),结直肠多发性息肉在Ⅰ型组中的检出率显著高于Ⅱ型组(73.6%比25.4%,P<0.05),腺瘤性息肉在Ⅰ型组中的检出率明显高于Ⅱ型组(73.6%比22.0%,P<0.05)。Ⅰ型组与Ⅱ型组间息肉直径大小差异无统计学意义(P=0.219)。左半结肠息肉在仅含VacA组中的检出率明显高于CagA+VacA组(59.1%比53.2%,P<0.05)及仅含CagA组(59.1%比42.3%,P<0.05),CagA+VacA组中腺瘤性息肉检出率高于仅含CagA组(80.6%比73.1%,P<0.05)和仅含VacA组(80.6%比54.5%,P<0.05)。CagA+VacA组、仅含CagA组和仅含VacA组间息肉数量比较差异无统计学意义(P=0.631)。[结论]不同毒力的Hp感染与结直肠息肉的生长部位、数量和病理类型有关,而与息肉的直径大小无关。感染同时表达CagA和VacA两种抗体的Hp时,结直肠息肉病理类型以腺瘤性息肉为主。[Objective]To investigate the relationship between different virulence Helicobacter pylori(Hp)infection and colorectal polyps.[Methods]According to the inclusion criteria and exclusion conditions,400 patients were selected as study objects.Patients with Hp infection diagnosed by13C or 14C urea breath test were tested for Hp serum antibody,and those with positive antibody were divided into Hp typeⅠantibody group and Hp typeⅡantibody group,and compared the different virulence Hp infection associated with colorectal polyps.Finally,according to the difference in Hp expression of cytotoxin associated gene A and vacuolation Toxin A,Hp seropositive individuals were divided into three groups:those expressing CagA and VacA,those expressing only CagA,and those expressing only VacA,to compare the differences in polyp characteristics among the groups.[Results]The detection rate of polyps in the HpⅠantibody-positive group was higher than that in the HpⅡantibody-positive group(94.5%vs 44.1%,P<0.05).The detection rate of polyps in the left colon in the HpⅠantibody group was higher than that in the HpⅡantibody group(51.8%vs 11.9%,P<0.05).The detection rate of colorectal multiple polyps in the HpⅠantibody group was significantly higher than that in the HpⅡantibody group(73.6%vs 25.4%,P<0.05).The detection rate of adenomatous polyps in the Hp typeⅠantibody group was significantly higher than that in the Hp typeⅡantibody group(73.6%vs 22.0%,P<0.05).There was no significant difference in polyp diameter between the Hp typeⅠantibody group and the Hp typeⅡantibody group(P=0.219).The detection rate of left colonic polyps in the VacA only expression group was significantly higher than that in the CagA and VacA antibody expression group(59.1%vs 53.2%,P<0.05)and the CagA only expression group(59.1%vs 42.3%,P<0.05),the detection rate of adenomatous polyps in the CagA and VacA antibody group was higher than that in the CagA only expression group(80.6%vs 73.1%,P<0.05)and the VacA only expression group(80.6%vs 54.5%%,P<

关 键 词：结直肠息肉 腺瘤性息肉 幽门螺杆菌 幽门螺杆菌抗体分型 

分 类 号：R730.269[医药卫生—肿瘤]