幽门螺杆菌感染的慢性胃炎与凋亡基因的相关性研究

Study on correlation between helicobacter pylori infection-associated gastritis and the apoptotic genes in gastric mucosa

目的探讨幽门螺杆菌(HP)感染相关胃炎程度与胃黏膜细胞凋亡基因表达的相关性。方法将2013年11～12月大坪医院消化内镜中心45例慢性胃炎患者纳入研究,快速尿素酶实验和13 C-呼气实验检测HP感染情况,病理分析HP感染部位胃炎严重程度,实时定量PCR(qRT-PCR)法检测HP感染部位胃黏膜组织和无HP感染的胃黏膜组织中凋亡相关基因Bax、Bak、Bcl-2的表达,Person相关分析HP感染的慢性胃炎程度与凋亡基因表达的相关性。结果 45例患者13 C-呼气实验和胃窦黏膜快速尿素酶实验均阳性,提示HP感染。病理结果显示45例(100%)患者均为慢性胃窦胃炎,其中28例(62.2%)为轻度,16例(35.6%)为中度,1例(2.0%)为重度;9例(20.0%)肠化生,5例(11.1%)低级别上皮内瘤变。45例患者胃体黏膜尿素酶实验阴性,提示无HP感染,其中6例胃体组织显示轻度慢性炎症(13.3%),39例无炎症(86.7%);无肠化生及上皮内瘤变。qRT-PCR结果显示HP感染胃黏膜中Bax mRNA的表达明显高于HP未感染胃黏膜患者(P<0.01)且与胃炎程度呈明显正相关(P<0.01),而Bak和Bcl-2的表达在两组间差异无统计学意义(P>0.05)。结论 HP感染的慢性胃炎程度与胃黏膜细胞凋亡呈正相关,提示HP感染可能导致胃上皮细胞中Bax基因的表达从而促进细胞凋亡。

Objective To investigate the correlation between Helicobacter pylori （HP） infection-associated gastritis and the ap-optotic genes in gastric mucosa .Methods Forty-five patients with chronic gastritis were registrated in our study from November 2013 to December 2014 .HP infection status in the patients was detected by using urease test and 13C-urea breath test .The degree of gastritis in the gastric mucosa with HP infection was confirmed via histopathology .qRT-PCR was used to measure the mRNA ex-pressions of Bax ,Bak and Bcl-2 in the gastric mucosa with HP infection and matched normal gastric mucosa .Person analysis was used to assess the correlation between the HP infection-associated gastritis and the mRNA expressions of Bax ,Bak and Bcl-2 in the gastric mucosa .Results Forty-five patients with HP infection in antrum and 45 patients （100% ） with chronic antrum gastritis were identified ,including 28 patients （62 .2% ） with light gastritis ,16 patients （35 .6% ） with moderate gastritis ,1 patient （2 .0% ） with severe gastritis .9 patients （20 .0% ）with metaplasia ,5 patients（11 .1% ） with low grade intraepithelial neoplasms .The urease tests were negative in the gastric body of 45 patients ,6 patients （13 .3% ）were mild chronic gastritis in the body ;Patient with meta-plasia and intrapithelial gastritis was not found .The Bax expression in the HP-infected gastric mucosa was markedly increased when compared with the normal gastric mucosa （P〈 0 .01） ,and positively correlated with the degree of gastritis （P〈 0 .01） , whereas the expressions of Bak and Bcl-2 have no significantly deferences bttween two groups（P〉0 .05） .Conclusion HP infec-tion-associated gastritis positively correlated with the expressions of apoptotic genes in gastric mucosa ,suggesting that HP infection might result in increasing the Bax expression and further enhancing the cell apoptosis .