幽门螺杆菌CagA-IgG/VacA-IgG在肠易激综合征中的应用价值

Application value of Helicobacter pylori CagA-IgG/VacA-IgG in irritable bowel syndrome

目的探讨幽门螺杆菌(Helicobacter pylori,Hp)CagA-IgG/VacA-IgG在肠易激综合征(irritable bowel syndrome,IBS)中的应用价值。方法采用14 C-UBT检测86例IBS患者(研究组)和80例健康体检者(对照组)的Hp,阳性者再进行CagA-IgG、VacA-IgG、UreA-IgG、UreB-IgG检测,比较2组Hp阳性率和CagA-IgG、VacA-IgG、UreA-IgG、UreB-IgG表达情况,并对Hp阳性IBS患者进行四联抗Hp治疗,观察其疗效。结果研究组Hp阳性率(52.33%)高于对照组(28.75%),研究组中腹泻型Hp感染率(66.67%)高于便秘型(38.64%),差异均有统计学意义(P<0.05)。研究组的CagA-IgG和VacA-IgG阳性率高于对照组,差异均有统计学意义(P<0.05),2组的UreA-IgG、UreB-IgG阳性率差异无统计学意义(P>0.05)。2组Hp阳性者Hp抗体分型差异具有统计学意义(P<0.05),其中研究组中HpⅠ型所占比例最高,对照组中HpⅡ型所占比例最高。抗Hp治疗后,IBS患者Hp根除率为77.78%;Ⅰ型、中间型患者IBS症状改善总有效率(76.67%)高于Ⅱ型患者(46.67%),腹泻型IBS症状改善总有效率(57.14%)低于便秘型(88.24%),差异均有统计学意义(P<0.05)。结论IBS与Hp感染密切相关,Hp CagA-IgG/VacA-IgG的检测可用于指导Hp阳性IBS患者的临床分层治疗。

Objective To explore the application value of Helicobacter pylori(Hp)CagA-IgG/VacA-IgG in irritable bowel syndrome(IBS).Methods 14 C-UBT was used to detect Hp in 86 IBS patients(study group)and 80 healthy subjects(control group).Those who were positive were tested for CagA-IgG,VacA-IgG,UreA-IgG,and UreB-IgG,and the positive rate of Hp and the expression of CagA-IgG,VacA-IgG,UreA-IgG,UreB-IgG were compared between the two groups.Quadruple anti-Hp treatment was given to Hp-positive IBS patients to observe its efficacy.Results Hp positive rate in the study group(52.33%)was higher than that in the control group(28.75%).The Hp infection rate of diarrhea type(66.67%)in the study group was higher than that of constipation type(38.64%),and the difference was statistically significant(P<0.05).The positive rates of CagA-IgG and VacA-IgG in the study group were higher than those in the control group(P<0.05).There was no statistically significant difference in the positive rate of UreA-IgG and UreB-IgG(P>0.05).There was a statistically significant difference in Hp antibody types between the two groups(P<0.05).Hp type Ⅰ accounted for the highest proportion in the study group,and Hp typeⅡaccounted for the highest proportion in the control group.After anti-Hp treatment,the Hp eradication rate of IBS patients was 77.78%,and the total effective rate of IBS symptom improvement in typeⅠand intermediate patients(76.67%)was higher than that in typeⅡpatients(46.67%).The total effective rate of diarrhea type IBS symptom improvement(57.14%)was lower than that of constipation type(88.24%),and the difference was statistically significant(P<0.05).Conclusions IBS is closely associated with Hp infection,and the detection for Hp CagA-IgG/VacA-IgG can be used to guide clinical stratification in Hp-positive IBS patients.