幽门螺杆菌抗体谱检测及对其致消化道疾病诊治的意义

Clinical significance of antibody detection in diagnosis and treatment of patients with Helicobacter pylori infection in upper gastrointestinal tract

目的了解幽门螺杆菌(H.pylori,Hp)的抗原表型特征,并评价Hp抗原表型分型对临床诊治意义。方法以确诊感染Hp的132例胃肠疾病患者和20例无症状体检者作为研究对象。用免疫印迹法检测Hp抗体谱,分析相应的Hp细胞毒素相关蛋白(CagA)、空泡毒素(VacA)、尿素酶(Urease)、鞭毛蛋白(Flagellin)及外膜蛋白(OMP)表达情况。结果HpI型的感染率PU组(88.89%)、GC组(93.33%)明显高于健康体检组(35%)和CG组(51.85%)(P<0.005)。小分子量OMP的检出率GC组(100.00%)和CG组(60.49%)明显高于健康体检组(25%)和PU组(33.33%)(P<0.05)。结论HpI型菌株比II型菌株致病力强更有可能增加胃癌发生风险,小分子量OMP可以作为胃癌及胃癌高发人群筛选的一种标志抗原;免疫印迹法是一种特异、敏感、可靠的确诊Hp感染的方法,值得推广应用。

Objective To understand the characteristic of Helicobacter priori （H. pylori, Hp） phenotypes and evaluate the clinical significance of phenotype differentiation. Methods 132 patients with gastroduedenal diseases and 20 volunteers without symptoms were observed. 132 patients were diagnosed as chronic gastritis （CG） （ n = 81 ）, peptic ulcer （PU） （ n = 36） and gastric cancer （GC） （n= 15） by endoscopy and histology. Western blotting was used to detect serum antibody to H. priori, cytotoxin- associated protein （CagA）, vacuolating cytotoxin （VacA）, urease, flagellin and outer membrane protein （OMP）. Results The infection rates of type Ⅰ strain in volunteers group without symptoms , group CG, PU group and GC group were 35 %, 51.85 %, 88.89 % and 93. 33 % respectively, showing significant differences between volunteers group without symptoms, group CG and PU group, GC group （ P 〈 0.005 ）. The expression rate of OMP in GC group and CG group were higher than that of PU group and volunteers group without marked symptoms （ P 〈 0.001 ）. Conclusion Type Ⅰ strain of Hp may be more pathogenic than type Ⅱ strain in lceding to gastric cancer. These low - molecular mass OMP should be taken as a marker for screening gastric cancer. Western blotting is a highly sensitive, specific, simple reliable, rapid and noninvasive test for detecting seunn antibody to Hp.