幽门螺杆菌毒力与胃十二指肠疾病相关性分析

Correlative analysis of Helicobacter pylori virulence and gastroduodenal diseases

目的通过分析门诊患者所感染幽门螺杆菌(H.pylori)菌株毒力与上消化道病变关系,探讨柳州地区H.pylori的致病特点。方法收集2014年6月—2015年5月于我院经14 C-UBT检测证实为H.pylori感染后经胃镜证实为慢性胃炎或消化性溃疡的门诊患者共125例,采集静脉血用蛋白芯片技术行H.pylori毒力细胞毒素相关蛋白(CagA)、空泡细胞毒素(VacA)、尿素酶(Ure)及热休克蛋白60(Hsp60)IgG检测,钳取胃黏膜组织行H.pylori银盐染色及病理检查。结果 125例患者以青年和中年为主,分别占48.00%和45.60%,均检出H.pylori相关毒力IgG抗体,其中CagA、VacA、CagA+/VacA+、Hsp60、Ure阳性率分别为92.80%、20.00%、19.20%、27.20%及96.80%;慢性胃炎、十二指肠溃疡及复合性溃疡CagA阳性率较胃溃疡高;所有病变中,消化性溃疡占86.40%(108/125);有123例患者完成病理检查,黏膜炎症程度表现为轻度、中度及重度的分别为17.90%(22/123),75.61%(93/123)及6.50%(8/123);81.30%(100/123)患者H.pylori染色阳性,为(+)^(+++)。结论在广西柳州地区,上消化道幽门螺杆菌相关性疾病患者以中青年居多,感染Hsp60及VacA阳性菌株低,发病主要以消化性溃疡为主,胃黏膜炎症程度以中度为主。

Objective To investigate the relationship between gastroduodenal diseases and Helicobacter pylori （H. pylori） virulence infected by outpatient patients and showed the role of H. pylori in pathogenesis of gastroduodenai diseases in Liuzhou. Methods From June 2014 to May 2015 a total of 125 outpatient patients infected with H. pylori proven by 14C-UBT at our hospital and then diagnosed with chronic gastritis or peptic ulcer by gastroscopy were enrolled in this study. The vein blood was drawn and H. pylori virulence cytotoxin associated protein （CagA）, vaceulating cytotoxin A （VacA）, urease （Ure）, heat shock protein （Hsp60） IgG were checked by protein combined array chip. method. Gastric mucosal tissues were clamped for silver staining and pathological examination for H. pylori. Results The majority of 125 patients were young and middle aged patients, accounting for 48.00 % and 45, 60 ~ respectively. All of them were found with H. pylori associ- ated virulence IgG antibodies. Among them, the positive rates of CagA, VacA, CagA＋/VaeA＋ , Hsp60, Ure were 92.80%, 20.00%, 19.20%, 27.20% and 96.80%. The positive rates of CagA in chronic gastritis, gas- troduodenal ulcer and complex ulcer were higher than that in gastric ulcer. In all the lesions, 86.40% （108/ 125） of them were peptic ulcer. A total of 123 patients finished pathologic examination. The percentages of mild-, moderate- and severe-mucosal inflammation were 17.90% （22/123）, 75.61% （93/123） and 6.50% （8/ 123） ,respectively. The percent of patients with H. pylori-positive staining was 81.30% （100/123）, the stai- ning-positive indicated from （＋） to （＋＋＋）. Conclusion Gastroduodenal diseases associated with H. pylori is common in young and middle aged people in Guangxi Liuzhou, with low infection with Hsp60 and VacA positive strains. Mainly patients with H. pylori developed into peptic ulcer; and the gastric mucosal inflammation was moderate.