CagA阳性幽门螺杆菌感染与胃十二指肠溃疡的相关性临床研究

Clinical study on the relationship between CagA positive Helicobacter pylori infection and gastroduodenal ulcer

目的 探讨Cag A阳性幽门螺杆菌感染与胃十二指肠溃疡的相关性。方法 将本院2014年8月-2015年8月收治的118例Cag A阳性消化性溃疡患者作为研究对象,均经内镜和活检病理确诊,包括胃溃疡38例、十二指肠溃疡50例,复合溃疡30例,另选择同期门诊体检正常健康人30例作为正常对照组,比较各组Hp阳性率。结果Cag A阳性的胃溃疡、十二指肠溃疡、复合溃疡的Hp阳性率分别为81.6%、86.0%、80.0%,组间比较差异无统计学意义（P〉0.05）,但三种Cag A阳性溃疡的Hp阳性率均显著高于正常对照组,差异具有统计学意义（P〈0.05）。98例Hp阳性消化性溃疡患者中,Hp根除治疗成功70例,其抗Cag A-Ig G抗体水平由治疗前的（69.34±16.77）U/m L逐渐降低,治疗后6个月水平显著低于治疗前及治疗后3个月,且治疗后3、6个月抗Cag A-Ig G抗体水平显著低于Hp根除治疗失败组,差异具有高度统计学意义（P〈0.01）。而Hp根除治疗失败组患者治疗前及治疗后3、6个月抗Cag A-Ig G抗体水平未见明显变化,差异无统计学意义（P〉0.05）。结论 Cag A阳性胃十二指肠溃疡患者发病与幽门螺杆菌感染密切相关,Hp引起消化性溃疡的致病机制也与Cag A密切相关。

Objective To investigate the relationship between CagA-positive helicobacter priori infection and gastro- duodenal ulcer. Method 118 patients with CagA positive peptic ulcer who were admitted in our hospital between Au- gust 2014 to August 2015 were selected as research subjects. They were pathologically diagnosed by endoscopy and biopsy, including 38 cases of gastric ulcer, 50 cases of duodenal ulcer and 30 cases of combined ulcer. At the same time, 30 healthy persons were selected as the normal control group, and the positive rate of lip in each group was compared. Results The Hp positive rates of gastric ulcer, duodenal ulcer and complex ulcer with positive CagA were 81.6%, 86.0%, 80.0% respectively. There was no significant difference between the two groups （P〉0.05）. The Hp positive rate of three CagA-positive ulcers was significantly higher than that of the normal control group, and the difference was significant （P〈0.05）. Among the 98 patients with Hp-positive peptic ulcer, Hp radical treatment was successful in 70 patients, and the anti-CagA-IgG antibody level was decreased from （69.34_＋16.77） U/mL before treatment and the level in 6 months after treatment was significantly lower than that before the treatment and 3 months after treatment, and the levels of anti-CagA-IgG antibody 3 months and 6 months after the treatment were significantly lower than that in Hp radical treatment failure group. The differences were statistically significant（P〈0.01）. There was no significant changes ih the anti-CagA-IgG antibody level before the treatment and 3 and 6 months after the treatment in Hp radical treatment failure group, and the differences were not statistically significant（P〉0.05）. Conclusion The occurrence of CagA-positive gastr/c ulcer is closely related to the infection of hdicobacter polyri, and the pathogenesis of peptic ul- cer induced by Hp is also closely related with CagA.