胃粘膜淋巴滤泡与幽门螺杆菌关系探讨

A preliminary study on the correlation between gastric lymphoid follicles and Helicobacter pylori infection

目的探讨含有细胞毒素相关基因 A（ cagA）菌株感染与胃粘膜淋巴滤泡形成之间的关系，并对胃粘膜淋巴滤泡的发生与幽门螺杆菌（ Hp）感染状况的关系等进行观察。方法对 655例慢性胃炎，消化性溃疡的患者进行胃镜检查，取胃窦粘膜组织作 Hp检测和组织病理检查，并选择 70份 Hp培养阳性的临床分离菌，用 PCR扩增法进行 cagA基因的检测。结果 Hp感染患者中胃粘膜淋巴滤泡的发生率（ 60.14％）显著高于非 Hp感染者（ 17.06％）；胃粘膜淋巴滤泡在活动性胃炎比非活动性胃炎中更易检测到；在 Hp相关性胃肠病中，慢性胃炎、胃溃疡、十二指肠球溃这三者之间胃粘膜淋巴滤泡的发生率无显著性差异。结论胃粘膜淋巴滤泡的发生直接与 Hp感染相关，并可作为一种 Hp感染相关性胃肠病中一个较为恒定的形态特征； Hp作为一种抗原剌激胃粘膜产生淋巴滤泡的作用与 Hp菌株的毒力（ cagA基因）无关。

Objective To investigate the correlation between H.pylori strain possessing cagA gene and the formation of gastric lymphoid follicles(GLF),and the effect of H.pylori infection on the occurrence of GLF.Methods Antral biopsy specimens from 655 patients (chronic gastritis:n=479,peptic ulcer:n=176)were used for detection of H.pylori infection and histological analysis. CagA gene was examined in 70 clinical isolates by means of PCR－ amplification. Results The incidence of lymphoid follicles in gastric mucosa is significantly higher(60.14％ ) in patients with H.pylori infection than those without infection(17.06％ ).GLF is easier to be detected in patients with active gastritis than in those with inactive gastritis. There is no significant difference in the presence of GLF among H.pylori associated gastroduodenal diseases,such as chronic gastritis ,gastric ulcer. Moreover, there is also no significant relationship between H.pylori strains possessing cagA gene and GLF. Conclusion The presence of GLF might directly related with H.pylori infection, and can be observed as a constant morpholgical marker of H.pylori related gastroduodenal disease ;The formation of gastric lymphoid follicles is not related to the cytotoxin of cag A gene of H.pylori.