胃十二指肠疾病患者中cagA阳性幽门螺杆菌的普遍易感性

Generalized infection of cagA-positive Helicobacter Pylon in Patients with Gastroduodenal Diseases

目的：明确ｃａｇＡ阳性幽门螺杆菌（Ｈ．Ｐｙｌｏｒｉ）在胃十二指肠疾病患者中的感染情况。方法：用聚合酶链反应（ＰＣＲ）方法扩增从３０例十二指肠球部溃疡、 ３０例慢性胃炎和６例胃癌，患者活检组织中分离培养出的Ｈ． Ｐｙｌｏｒｉ菌株的ｃａｇＡ基因片段，用酶联免疫吸附测定（ＥＬＩＳＡ）方法检测血清抗Ｈ．Ｐｙｌｏｒｉ抗体，用免疫印迹（Ｗｅｓｔｅｒｎ ｂｌｏｔ）方法检测血清抗ＣａｇＡ抗体。结果：用ＰＣＲ方法测得的ｃａｇＡ基因阳性率为：十二指肠球部溃疡７０％（２１／３０），慢性胃炎７３％（２２／３０），胃癌８３％（５／６）。６６份血清标本抗Ｈ． Ｐｙｌｏｒｉ抗体均为阳性。用Ｗｅｓｔｅｒｎ ｂｌｏｔ方法测得的抗ＣａｇＡ抗体阳性率为：十二指肠球部溃疡８３％（２５／３０），慢性胃炎７７％（２３／３０），胃癌８３％（５／６）。结论：在我国人群中，ｃａｇＡ基因不能作为消化性溃疡的标志物，ｃａｇＡ阳性Ｈ． ｐｙｌｏｒｉ在消化性溃疡和慢性胃炎患者中存在普遍易感性。

Background/Aims: To investigate the infectious status of cagA-positive Helicobacter Pylon (H. Pylon) strains in patients with duodenal ulcer (DU), chronic gastritis (CG) and gastric carcinoma (GC). Methods: 66 strains of H. Pylon from biopsied specimens were obtained from 30 patients with DU, 30 CG and 6 GC. The presence of cagA gene was examined by polymerase chain reaction (PCR), the serum anti-H. Pylon antibody was detected by enzyme-linked immunosorbent assay (ELISA), while the serum anti-CagA IgG was detected by Western blot analysis. Results: The cagA gene was detected in 70% (21/30) DU, 73% (22/30) CG and 83% (5/6) GC patients. All patients were seropositive for H. Pylon antibody IgG. Anti-CagA IgG was detected in 83% (25/30) DU, 77% (23/30) CG and 83% (5/6) GC patients. Conclusions: These results indicate that cagA cannot be used as a marker for DU among Chinese patients. The prevalence of cagA-positive H. Pylon in patients with CG is also high.