幽门螺杆菌CagA抗体与胃十二指肠疾病的相关性探讨

Correlation between CagA Antibody Against Helicobacter pylori and the Gastroduodenal Diseases

目的探讨本地区表达细胞毒素相关蛋白A(CagA)的幽门螺杆菌(HP)与胃十二指肠疾病的关系。方法将127例消化系统疾病患者分为四组。采用金标免疫斑点法检测各组患者血清中HP抗体,采用间接ELISA法测定各组CagA-IgG,并作组间的比较。结果慢性胃炎(CG),十二指肠溃疡(DU),胃溃疡(GU),胃癌(GC)患者及无症状组(AC)血清中HP抗体的检出率分别为74.2%,85.7%,81.5%,77.8%,61.6%,CagA-IgG的检出率分别为61.3%,66.7%,63.0%,70.4%,34.0%。经χ2检验显示,在DU与GU组,HP及CagA+HP感染率均明显高于AC组(P<0.05、P<0.01),而CG及GC组与AC组比较,HP感染率无显著性差异(P>0.05),而CagA+HP感染率仍有显著性差异(P<0.01)。各胃肠疾病组间的HP及CagA+HP感染率均无显著性差异(P>0.05)。结论在广州地区,仅DU与GU组的HP感染率高于AC组,而CagA+HP感染率在CG、DU、GU与GC组,均高于AC组,可见CagA-IgG的表达情况,可为胃十二指肠疾病的致病因素与诊疗、防治提供依据,但不能作为区分CagA+HP感染所致胃十二指肠疾病的单一指标。

Objective To investigate the correlation between cytotoxin associated gene A（CagA） expressing Helicobocter pylori （HP） and the gsstroduodenal diseases in the duodenum. Methods 127 cases suffered from digestive system diseases were divided into four groups. Serum HP antibodies were determined with immunognld filtration method and CagA-IgG was measured by indireet ELISA. Comparision was performed among the groups. Results The positive rates of serum HP antibodies in patients with chronic gastritis （CG）, duodenal ulcer （DU）, gastritis ulcer（GU）, gastritis cancer（GC） and asymptomatic control（AC） were 74.2%, 85.7%, 81.5%, 77.8%, and 61.6%, respectively. The positive rates of CagA-IgG in the corresponding groups mentioned above were 61.3%, 66.7%, 63.0%, 70.4%, and 34.0%, respectively. It showed that the positive rates of HP and CagA^＋HP in DU and GU groups were significantly higher than that in AC group （P〈0.05, P〈0.01）. There was no significance difference of the positive rates of HP infection between CG, C,C and AC （P〉0.05）. CagA^＋HP infection in CG and C,C was significantly higher than that in AC group （P〈0.01）. There was no significance of the positive rates of HP and CagA^＋ HP among the gastroduodenai diseases groups （P〉0.05）. Conclusions The positive rates of HP infection in patients with DU and CU were higher than that in control group while the positive rates of CagA^＋HP infection in patients with CG, DU, GU and GC were all higher than that in control group. Therefore, the expression of CagA-IgG was helpful for us to invesitigate the pathogenetic factors of the gastroduodenal disease and to prevent and cure it. However, it was not the exclusive standard for identification of the gastroduodenal disease