胆囊内胆汁幽门螺杆菌DNA检出与胃幽门螺杆菌感染的关系

Correlation between Helicobacter pylori DNA positive detection in bile of gallbladder and intragastric Helicobacter pylori＇s colony.

目的探讨胆囊内胆汁幽门螺杆菌（Hp）DNA检出与胃Hp感染的关系及可能的机制。方法采用^13C-呼气实验检测60例胆囊良性疾病患者胃幽门螺杆菌，并根据结果分为胃Hp感染阳性组和胃Hp感染阴性组，用PCR方法检测2组患者的胆汁及结石Hp细胞毒素相关基因抗原（cagA），另选健康人30名作为对照，B超测定3组胆囊排空率。结果60例胆囊良性疾病患者胃Hp感染率为50．0％（30／60），胃Hp感染阳性组胆汁标本中cagA阳性7例（23．3％，7／30），结石标本中cagA阳性1例（3．3％，1／30），胃Hp感染阴性组胆汁和结石标本均为阴性，2组胆汁cagA检出率差异有统计学意义（Х^2=5．822，P〈0．05），胃Hp感染阳性组胆囊收缩率[（56．8±17．1）％]明显低于胃Hp感染阴性组[（69．4±13．1）％]和对照组[（63．3±17．1）％]，差异有统计学意义（F=5．633，P〈0．05）。结论胆囊内胆汁中存在HpDNA，且与胃Hp感染明显有关，胆囊排空功能障碍参与了这一过程。

Objective To study the relationship between Helicobacter pylori （Hp） DNA positive detection in bile of gallbladder and intragastric Hp＇s colony and its plausible mechanism. Methods Sixty patients of gallbladder innocence diseases were recruited in the case group and 30 health populations were recruited in the control group. ^13CPDB was used to detect the infection of Hp. The cytotoxin associated gene antigen （cagA） in gall and gall-stone were detected through PCR. The empty function was tested through B ultrasound. Results The infection rate of Hp in all cases is 50. 0% （ 30/60 ） and 7 of 30 bile （ 23.3% ）, 1 of 30 gallstones （ 3.3% ） were positive for Hp cag-A by PCR analysis in positive Hp infection group, with none of the 30 bile were positive in negative group（ Х^2 = 5. 822 ,P 〈 0. 05 ）. The contraction rate of gallbladder of Hp positive group （ 56. 8 ± 17. 1 ） % was lower than negetive group＇ s （ 69.4 ± 13.1 ） % and the control group＇ s （ 63.3 ± 17.1 ） % （ F = 5. 633, P 〈 0.05）. Conclusions Hp DNA is present in bile of gallbladder, and is related with Hp infection in stomach. Impairment of the gallbladder empty function may be related with Hp infection.