幽门螺杆菌感染与胃粘膜淋巴滤泡关系探讨

Preliminary Study on the Correlation between Gastric Lymphoid Follicles and Helicobacter pylori Infection

目的 :为了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 :我们对 65 5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 ( 17.0 6% ) ;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 ;另外 ,还观察到含cagA基因的Hp菌株与胃粘膜淋巴滤泡的增生两者之间无相关性。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 ,任何Hp感染均可剌激胃粘膜产生淋巴滤泡。

Objective: To investigate the correlation between H. pyl ori strain with cagA gene and gastric lymphoid follicles (GLF), the effect of H. pylori infection on the occurrence of GLF. Methods: 655 patien ts with chronic gastritis and peptic ulcer underwent fiber gastroscopy together with gastric mucosal biopsy for detection of H. pylori and pathologic examinatio n cagA gene was examined in 70 clinical positive H. pylori isolates by means of PCR -amplification. Results: The incidence of lymphoid follicles in gastric muco sa was significantly higher (60.14%) in patients with H.pylori infection than th ose w ithout H. pylori infection (17.06%). GLF was easier to be detected in patients w i th active gastritis than inactive ones. There was no significant difference for the occurence of GLF among H.pylori associated with gastroduodenal diseases, suc h as chronic gastritis, gastric ulcer. Moreover, there was also no marked relati onship between H. pylori strains possessing cagA gene and GLF. Conclusion: The result suggests that the presence of GLF may directly associate with H. pylori i nfection, and can be served as a constant morphologic characteristic of H. pylo ri related gastroduodenal diseases. The effect of H. pylori as an antigen inducing gastric mucosa to produce lymphoid follicles may not be associated with toxicity (cagA gene)of H.pylori strains.