炎症性肠病患者幽门螺杆菌感染的血清学状况  

Serologic Presentation of Helicobacter Pylori Infection in Patients With Inflammatory Bowel Disease

作　　者：何晋德[1] 刘玉兰[1] 叶辉[1] 张娇[1] 

机构地区：[1]北京大学人民医院消化科,北京100044

出　　处：《中国医师杂志》2003年第6期737-738,共2页Journal of Chinese Physician

摘　　要：目的　研究幽门螺杆菌 (Hp)在炎症性肠病 (IBD)患者中的血清学表现以及Hp在IBD发生中的作用。方法　以慢性胃炎为对照配对 (性别相同、年龄相似 )检测 4年间IBD患者血清中抗 -Hp -IgG和抗 -Hp -CagA并分析它们与溃疡性结肠炎 (UC)病变范围的关系。结果　IBD患者共 45例 ,其中UC 40例 ,Crohn病 (CD) 5例 ;抗 -Hp -IgG (+ )率IBD患者 (4 0 0 % )较慢性胃炎(66 7% )低 (χ2 =6 43 ,P <0 0 5 ) ,其中UC患者及其对照分别为 42 5 %和 65 0 % (χ2 =4 0 7,P <0 0 5 ) ,CD患者抗 -Hp -IgG(+ )者为 1/ 5 ;UC患者中抗 -Hp -IgG(+ )率全结肠受累者 (2 8 0 % )比部分结肠受累者 (66 7% )低 (χ2 =5 74,P <0 0 5 ) ;抗 -Hp -CagA(+ )率在IBD及其对照分别为 2 8 9%和 40 0 % (P >0 0 5 ) ,全结肠和部分结肠受累的UC患者分别为 2 8 0 %和 40 0 % (P >0 0 5 )。结论　IBD患者中抗 -Hp -IgG(+ )率处于较高水平 ,但比慢性胃炎低 ;Hp感染对UC的病变范围可能有抑制作用 ;IBD患者及全结肠受累的UC患者抗 -Hp -CagA(+ )率较低 。Objective To investigate serologic manifestation of Helicobacter Pylori (H. pylori) infection in patients with inflammatory bowel disease (IBD) and the role of H. pylori infection in pathogenesis of IBD.Methods We measured anti-H.pylori-IgG and anti-H.pylori-CagA of 45 IBD patients and their with sex and age matched 45 chronic gastritis(CG) control patients during 4 years, and analyzed the relationship between seroprevalence of H.pylori and inflammatory range of ulcerative colitis(UC).Results There were 40 UC patients and 5 Crohn's disease(CD) patients; the positive anti-H.pylori-IgG patients in IBD was 40 0% and in chronic gastritis was 66 7% respectively(χ 2=6 43,P<0 05),in UC and its control were 42 5% and 65 0% respectively(χ 2=4 07,P<0 05),anti Hp-IgG positive patients counted for 20 percent. The anti-H.pylori-IgG positive rate of pan-colorectal UC was lower than partial-colorectal UC (28 0% versus 66 7%, χ 2=5 74,P<0 05). The positive anti-H.pylori-CagA patients were 28 9% and 40 0% in IBD and its control respectively (P0 05), and that were 28 0% in pan-colorectal UC and 40 0% in partial-colorectal UC (P>0 05).Conclusions The anti-H.pylori-IgG positive rate is in high level in IBD patients, but that is lower than chronic gastritis patients.H. pylori infection could play a inhibition role in the inflammation range of UC. The anti-H.pylori-CagA positive rate of IBD patients and pan-colorectal UC are lower than their controls respectively, but there is no obviously different in statistics.

关 键 词：炎症性肠病 CROHN病 溃疡性结肠炎 幽门螺杆菌 

分 类 号：R574[医药卫生—消化系统] R446.11[医药卫生—内科学]