幽门螺杆菌在原发性胆总管结石患者胆汁和胆石中的表达

Detection of Helicobacter pylori DNA in bile and gallstone of patients with primary choledocholithiasis

目的:研究原发性胆总管结石(primary choledocholithiasis)患者胆汁和胆石中幽门螺杆菌(Helicobacter pylori,H.pylori)的表达.方法:采用对照研究方法,对原发性胆总管结石患者(试验组)32例和对照就诊者(对照组)30例行内镜下逆行胰胆管造影术(ERCP)采用实时荧光定量PCR法检测胆汁及胆石中H.pylori DNA表达.结果:利用比较平均循环数值(Ct)法测定H.pylori DNA的表达水平,原发性胆总管结石组胆汁H.pylori DNA Ct值为16.78±9.28,对照组胆汁Ct值3.75±7.71,两组之间H.pyloriDNA表达比较,差异具有统计学意义(P<0.01)分组两两比较胆色素结石组(16例),胆固醇结石组(5例),混合性结石组(11例)间胆汁及胆石中H.pylori DNA表达,无统计学差异(P>0.05).结论:原发性胆总管结石患者胆汁及胆石中存在H.pylori表达,但H.pylori表达与结石类型无明显相关,其高表达提示H.pylori可能参与了原发性胆总管结石的发生及发展,但其具体作用机制有待进一步研究.

AIM：To detect Helicobacter pylori （H.pylori） DNA in bile and gallstone of patients with primary choledocholithiasis. METHODS：Thirty-two patients with primary choledocholithiasis （experiment group） and 30 control subjects （control group） were included in the study. All the patients underwent endoscopic retrograde cholangiopancreatography （ERCP）. H.pylori DNA in bile and gallstone was detected by real-time PCR. RESULTS：The cycle threshold （Ct） value obtained from bile of patients with primary choledocholithiasis was significantly higher than that from bile of control subjects （16.78 ±9.28 vs 3.75 ±7.71,P 0.01）. No significant differences were noted in H.pylori DNA levels in bile and gallstone among patients with bile pigment calculi,those with cholesterol stones and those with mixed stones （P 0.05）. CONCLUSION：H.pylori DNA can be detected in bile and gallstone of patients with primary choledocholithiasis. H.pylori DNA level is not correlated with stone type. H.pylori present in bile and gallstone of patients with primary choledocholithiasis may play an important role in the development of primary choledocholithiasis.