幽门螺杆菌抗体检测分析

Detection and analysis of Helicobacter pylori antibodies

目的对昆明地区感染幽门螺杆菌(H.pylori)人群检测血清CagA、VacA、Ure、Hsp60、RdxA五种IgG抗体,了解其与消化性溃疡、慢性胃炎的关系。方法抽静脉血3mL离心取血清,用H.pylori抗体芯片检测CagA、VacA、Ure、Hsp60、RdxA五种IgG抗体。结果①CagA抗体总阳性率为79.7%,十二指肠球部溃疡(DU)、慢性胃炎(CG)、胃溃疡(GU)的CagA抗体阳性率分别为88.0%、60.9%、83.3%,DU的CagA抗体检出率明显高于CG(P=0.008),而DU与GU(P=0.744)、CG与GU(P=0.633)之间的差异无统计学意义;②VacA抗体总阳性率为20.3%,DU、CG、GU的VacA抗体阳性率分别为14.0%、30.4%、33.3%,三者之间的差异无统计学意义(P=0.12);③Ure抗体总阳性率为97.5%,DU、CG、GU的Ure抗体阳性率分别为98%、95.7%、100%,三者之间的差异无统计学意义(P=0.534);④Hsp60抗体总阳性率为6.25%,DU、CG、GU的Hsp60抗体阳性率分别为4.0%、13.0%、0%,三者之间的差异无统计学意义(P=0.317);⑤RdxA抗体总阳性率为17.5%,DU、CG、GU的RdxA阳性率分别为14.0%、30.4%、0%,三者之间的差异无统计学意义(P=0.179)。结论昆明地区H.pylori感染人群CagA抗体阳性率为79.7%,与DU的关系更加密切;CagA、VacA抗体不能单独作为H.pylori感染阳性的标志物;Hsp60抗体水平对于H.pylori感染的检测价值不大;RdxA抗体水平不能标志甲硝唑耐药的水平;而Ure抗体阳性率高达97.5%,可作为H.pylori感染阳性的标志物,我们认为检测H.pylori血清抗体用于H.pylori感染的流行病学调查,应该以Ure抗体为主,辅以CagA抗体和VacA抗体。

Objective To detect IgG antibodies of H. pylori： CagA, VacA, Ure, Hsp60, RdxA. Disclose their relations with peptic ulcer and chronic gastritis. Methods Three mL venous blood was taken to centrifugate and detect antibodies： CagA,VacA,Ure,Hsp60,RdxA. Results ① The positive rates of CagA antibody were 79.7% ,88.0% for DU, 60.9% forCG and 83.3% forGU. DUvs CG（P=0.008）, DU vs GU（P=0.744）,CG vs GU（P=0.633）.② The positive rates of VacA antibody were 20.3% , 14.0% for DU,30.4% for CG and 33.3% for GU （P = 0. 12）. ③ The positive rates of Ure antibody were 97.5% ,98% for DU ,95.7% for CG and 100% for GU （P = 0. 534）. ④ The positive rates of Hsp60 antibody were 6.25% ,4.0% for DU, 13.0% for CG and 0% for GU （P = 0. 317）. ⑤ The positive rates of RdxA antibody were 17.5% , 14.0% for DU ,30.4% for CG and 0% for GU （P = 0. 179）. Conclusion The positive rates of CagA antibody were 79.7%. CagA is closer to DU than that to CG. Antibodies of CagA and VacA can not act as the symbol of H. pylori infection alone. To determine H. pylori infection, the value of Hsp60 is little. The level of RdxA antibody can not represent the level of H. pylori resistance to metronidazole. The positive rates of Ure antibody reached to 97.5%. Ure antibody can act as the symbol of H. pylori infection.