胃肠道相关疾病患者幽门螺杆菌CagA抗体阳性率分析

Distribution and relationship of Helicobacter pylori CagA antibody in gastric correlation disease

目的探讨胃肠道相关疾病患者幽门螺杆菌(HP)感染、CagA抗体检测阳性与所患疾病类型间的关系。方法纳入研究的对象包括本院消化内科住院的320例胃肠道相关疾病患者和同期于本院进行体检的健康体检者200例,共520例。采用蛋白质印迹(WB)法和13 C-尿素呼气试验对520例上述人群进行HP感染的检测,采用WB检测CagA抗体,并对检测结果进行比较分析。结果 320例患者和200例健康体检者13 C-尿素呼气试验阳性率分别为60.9%(195/320)和55%(110/200),WB检测HP抗体的阳性率分别为68.4%(219/320)和61.0%(122/320)。2种方法检测HP感染的阳性率差异无统计学意义(P>0.05);患者和健康体检者HP感染的阳性率差异无统计学意义(P>0.05)。慢性胃炎、胃及十二指肠溃疡、食管炎、胃癌患者及健康体检者CagA抗体的阳性率分别为43.1%、66.7%、51.3%、70.0%、21.5%;不同胃相关疾病患者CagA抗体阳性率的差异无统计学意义(P>0.05);不同胃肠道相关疾病患者CagA抗体阳性率均高于健康体检者(P<0.05)。结论 CagA是HP分泌的重要毒力因子之一,感染的HP大多数为CagA阳性菌株,抗体阳性较阴性者更易放生严重的组织炎症和损伤,同胃肠道相关疾病的发生密切相关。

Objective Discuss the relationship between the infection status with positive CagA antibody of Patients with HP in- fection and gastric correlation disease. Methods Western Blot （WB） was applied to test 320 samples from clinical patients,13 C- u- rea breath test was applied to test HP,western blot was applied to test HP and CagA antibody. Results 320 cases patients and 80 cases are asymptomatic healthy checkup, in 13 C- urea breath test, 195 of 320 patients were positive, 110 of 200 asymptomatic healthy checkup were positive respectively, positive rate were 60.9% and 55 % respeetively^in HP antibody detection using western blot, 219 cases （68.4%） were positive and 122 cases （61.0%） were positive,respectively. There was no significant difference in the HP positive rate between two methods （P〉0.05）;no significant difference in the HP positive rate between patients and control（P〉0.05）. CagA antibody positive rate were 62 %, 66.7%,51.2%, 70 %, 35.2 % in chronic gastritis （CG）, gastric and duodenal ulcer （PU）, esophagitis （RE）, gastric cancer （GC） patients and control （AC）, respectively. No significant difference in the CagA antibod- y positive rate among various groups of gastrbintestinal diseases （P〉0.05）. Conclusion CagA is one of the most important viru- lence factor secreted by HP. Most infected HP are CagA positive strains,and antibody positive strains are closely correlated to gas-tric diseases.