胃幽门螺杆菌感染患儿细胞毒素相关基因A和细胞空泡毒素A与十二指肠疾病

Serum CagA and VacA detection and Helicobacter pylori associated gastroduodenal disease

目的 了解幽门螺杆菌（Ｈｐ） 阳性患儿感染的Ｈｐ 菌株类型，探讨细胞毒素相关基因Ａ（ＣａｇＡ） 、细胞空泡毒素Ａ（ＶａｃＡ）与小儿慢性胃炎、消化性溃疡病发生之间的关系。方法 采用免疫印迹法对３３ 例十二指肠溃疡、３１ 例慢性胃炎患儿做血清Ｈｐ 的１１６ ０００（ＣａｇＡ） 、８９ ０００ （ＶａｃＡ） 、３５ ０００ 、３０ ０００ 、２６ ５００ 和１９ ５００ 蛋白抗体的检测。结果 在十二指肠溃疡患儿８９ ０００ 检出率达７２％ ，而慢性胃炎仅为２３％ ，但ＣａｇＡ在溃疡与胃炎患儿中差异不显著。以ＣａｇＡ、ＶａｃＡ结合分型发现，在十二指肠溃疡患儿６９％ 的Ｈｐ 为ＣａｇＡ＋ 、ＶａｃＡ＋ 菌，而在慢性胃炎中６８％ 的Ｈｐ 为ＣａｇＡ＋ 、ＶａｃＡ－ 菌，两者比较差异有显著性（ Ｐ＜ ０．０５）。结论 小儿十二指肠溃疡及中、重度胃炎的发生与感染Ｈｐ 的毒力菌株相关，ＶａｃＡ很可能是致溃疡的毒力因素。

Objective To study the strains of Helicobacter pylori (Hp) in infected children and relationship between Hp CagA and VacA and gastroduodenal disease development Methods The serum 116 000 (CagA), 89 000 (VacA), 35 000, 30 000, 26 500 and 19 500 of Hp protein were analyzed by Western blot in 33 duoderal ulcer (DU) and 31 chronic gastritis patients Result The detection rate of 89 000 was 72%, which was higher than that in gastritis patients (23%); CagA detection rate was not significantly different between DU and gastritis groups, CagA + and VacA + strain was 69% in DU group, CagA + and VacA - was 68% in chronic gastritis group The differences between the groups were very significant Conclusion Children′s DU and gastritis, particularly the moderate and severe ones were associated with Hp virulent strains The VacA might be the virulent factor causing ulcer