幽门螺杆菌细胞毒素相关蛋白、空泡毒素基因与儿童胃十二指肠疾病的关系  

Relationship between cytotoxin associated protein and vacuolating cytotoxin of helicobacter pylori and gastroduodenal disease in children

作　　者：胡伟国[1] 黄开宇[1] 朱欢[1] 徐辉[1] 徐彰[1] 黄爱芬[1] 程芹芹[1] 陶洪群[2] 谢小志[3] 杨锦红[2] 

机构地区：[1]浙江省温州医学院附属育英儿童医院消化科,温州325000 [2]浙江省温州医学院附属育英儿童医院检验科,温州325000 [3]浙江省温州医学院附属育英儿童医院病理科,温州325000

出　　处：《实用儿科临床杂志》2003年第11期884-886,共3页Journal of Applied Clinical Pediatrics

基　　金：温州市科技发展计划项目 (项目编号 :S2 0 0 2A0 3 9)

摘　　要：目的　探讨幽门螺杆菌 (Hp)细胞毒素相关蛋白 (cagA)、空泡毒素 (vacA)与儿童胃十二指肠疾病类型及胃黏膜炎症程度的关系。方法　采用免疫印迹法测定 88例Hp相关性慢性胃炎 (CG)、4 6例Hp相关性消化性溃疡 (PU)患儿血清cagA、vacA抗体 ,并观察胃黏膜病理变化。 结果　 1.CagA、vacA抗体总检出率分别为 85 .0 7%、91.0 4 % ,cagA抗体在CG与PU中检出率分别为 84 .0 9%与 86 .96 % ,两组相比无显著性差异 (P>0 .0 5 ) ;vacA抗体在CG与PU中检出率分别为 89.77%与 93.4 8% ,两组相比无显著性差异 (P >0 .0 5 )。 2 .134例Hp感染患儿cagA、vacA抗体均阳性 (Ⅰ型菌 ) 113例 ,cagA、vacA抗体均阴性 (Ⅱ型菌 ) 11例 ,cagA、vacA抗体仅一项阳性 (中间型 ) 10例 ,各型菌株在CG、PU中的检出率无明显差异 (P均 >0 .0 5 )。 3.113例Hp Ⅰ型菌株感染引起胃黏膜中重度炎症占 88.5 0 % ,而Ⅱ型菌株、中间型菌株感染引起胃黏膜中重度炎症分别为 4 5 .4 5 %及 5 0 .0 0 % ,两组有显著性差异 (P <0 .0 1)。结论　CagA、vacA与CG、PU发病均有关 ,不能作为区分Hp感染致不同胃十二指肠疾病的特异性指标。本地区儿童感染的Hp主要为cagA和vacA阳性的Ⅰ型菌株 。Objective To explore the relationship between cytotoxin associated protein (cagA) and vacuolating cytotoxin (vacA) of helicobacter pylori (Hp) and types of gastroduodenal disease in children, and the severity of inflammation in gastric mucous. Methods The serum cagA and vacA antibodies were measured by the immune imprint method in 88 children with Hp related chronic gastritis and 46 children with Hp related peptic ulcer. The gastric biopsy specimens of all children were studied histologically.Results 1.The detection total rate of cagA and vacA antibody was 85.07 % and 91.04 %. The detection rate of cagA antibody was 84.09 % in chronic gastritis and 86.96 % in peptic ulcer. The detection rate of vacA antibody was 89.77 % in chronic gastritis and 93.48 % in peptic ulcer. Neither difference of detection rate of cagA antibody nor of vacA antibody between 2 groups was significant ( P >0.05).2.In 134 Hp infected children, we found 113 cases with both cagA and vacA antibodies positive (Hp typeⅠstrain), 11 cases with both cagA and vacA antibodies negative (Hp typeⅡ strain), and 10 cases with either cagA or vacA antibody positive (Hp intermediate type strain). There was no significant difference in the detection rate of all types of Hp strain in chronic gastritis and in peptic ulcer ( P > 0.05 ).3.The percentage of gastric mucosal moderate-severe inflammation was 88.50 % in children with Hp typeⅠstrain, 45.45 % in children with Hp type Ⅱ strain, and was 50.00 % in children with Hp intermediate type strain. There was very significant difference in the severity of inflammation in gastric mucous caused by different types of Hp strain ( P <0.01).Conclusions As the cagA and vacA were both associated with the occurrence of chronic gastritis and peptic ulcer, they were not specific marker for the discrimination of Hp strains with respect to various gastroduodenal diseases.Findings showed that the type of Hp infection in children was mainly Hp typeⅠstrain which might cause more severe inflammation i

关 键 词：幽门螺杆菌 细胞毒素相关蛋白 空泡毒素 抗体 胃炎 慢性 溃疡 消化性 

分 类 号：R725.7[医药卫生—儿科]