幽门螺杆菌感染患儿胃黏膜炎症程度与菌株定植密度及细胞毒素相关蛋白的关系

Relationship between the severity of inflammation, the density of bacterial colonization in antral mucosa and cytotoxin associated protein in Helicobacter pylori-related chronic gastritis in children

目的:探讨幽门螺杆菌(H.pylori)相关性慢性胃炎患儿胃窦黏膜炎症程度、H.pylori定植密度及其细胞毒素相关蛋白(CagA)三者之间的关系。方法:对79例H.pylori相关性慢性胃炎患儿行胃镜检查,取胃窦黏膜经HE及改良Giemsa染色后观察胃窦黏膜炎症程度及H.pylori定植密度,并采用免疫印迹法检测患儿血清CagA抗体。结果:63例胃窦黏膜中重度炎症患儿血清CagA抗体阳性58例(占92.06%),而16例胃窦黏膜轻度炎症患儿血清CagA抗体阳性9例(占56.25%),两者差异有显著性(χc2=10.076,P=0.002),而两组患儿胃窦黏膜H.pylori定植密度无明显差异(rs=0.097,P=0.394);胃窦黏膜不同H.pylori定植密度患儿血清CagA抗体检出率无明显差异(H=0.246,P=0.884)。结论:H.pylori相关性慢性胃炎患儿胃窦黏膜炎症程度与CagA有关,而与H.pylori在胃窦部的定植密度无相关,CagA阳性的H.pylori菌株能引起胃窦黏膜较重的炎症;H.pylori在胃窦部的定植密度与CagA无相关。

Objective: To explore the relationship between the severity of inflammation, the density of Helicobacter pylor colonization in antral mucosa and cytotoxin associated protein (CagA) in Helicobacter pylori-related chronic gastritis in children. Methods: 79 children with Helicobacter pylori-related chronic gastritis were referred for endoscopy, antral mucosal biopsy specimens were obtained to be processed by HE and Giemsa stain to identify the severity of inflammation and the density of Helicobacter pylor colonization. The serum CagA antibody was measured by the immune blotting method. Results: There were 58 children with positive CagA antibody in 63 children with antral mucosal moderate-severe inflammation, but it was 9 cases in 16 children with antral mucosal mild inflammation, The difference was statistically significant between two groups (χc2=10.076,P=0.002), but there were no significant difference in the Helicobacter pylori colonization density between two groups (rs=0.097,P=0.394). The detection rate of CagA antibody was not signifi- cant in children with different Helicobacter pylori colonization density (H=0.246,P=0.884). Conclusion: The severity of antral mucosal inflammation correlated with CagA, but not with the Helicobacter pylori colonization density in Helicobacter pylori-related chronic gastri- tis in children. The strains of Helicobacter pylori with positive CagA may cause more severe inflammation in antral mucousa. there was no correlation between CagA and Helicobacter pylori colonization density in antral mucosa.