慢性胃炎胃黏膜组织及血清标志物与Hp感染的关联

Association between gastric mucosal tissues,serum markers and Hp infection in patients with chronic gastritis

目的探讨慢性胃炎患者胃黏膜组织微小核糖核酸-22(miR-22)、细胞毒素相关蛋白A(CagA)及血清硫氧还蛋白-1(TRX-1)、胃蛋白酶原Ⅱ(PGⅡ)与幽门螺杆菌(Hp)感染的关联。方法选取90例2020年3月-2023年3月南阳医学高等专科学校第一附属医院收治的慢性胃炎患者为研究对象,根据Hp检测结果分为Hp感染组29例和Hp未感染组61例,分析两组患者胃黏膜组织病理诊断结果、肠道菌群分布、胃黏膜组织miR-22、CagA和血清TRX-1、PGⅡ水平。结果Hp感染组慢性萎缩性胃炎、炎性活动、炎性程度中重度、有淋巴滤泡形成、有上皮肠化患者占比高于Hp未感染组(P<0.05);Hp感染组大肠埃希菌、乳酸杆菌、双歧杆菌数量低于Hp未感染组(P<0.05),嗜酸乳杆菌数量高于Hp未感染组(P<0.05);Hp感染组胃黏膜组织miR-22水平低于Hp未感染组(P<0.05),胃黏膜组织CagA及血清TRX-1、PGⅡ水平高于Hp未感染组(P<0.05);胃黏膜组织miR-22、CagA及血清TRX-1、PGⅡ联合检测诊断慢性胃炎患者Hp感染的曲线下面积(AUC)值为0.940,敏感度和特异度分别为96.55%和80.33%。结论Hp感染与慢性胃炎患者病情进展有关,可致患者肠道菌群紊乱,胃黏膜组织miR-22在慢性胃炎Hp感染患者中呈低表达,而CagA及血清TRX-1、PGⅡ呈高表达,四者联合检测的诊断价值较高。

OBJECTIVE To explore the association between the gastric mucosal tissue microribonucleic acid-22(miR-22),cytotoxin-associated protein A(CagA),serum thioredoxin-1(TRX-1),pepsinogenⅡ(PGⅡ)and the Helicobacter pylori(Hp)infection in the patients with chronic gastritis.METHODS Totally 90 patients with chronic gastritis who were treated in the First Affiliated Hospital of Nanyang Medical College from Mar 2020 to Mar 2023 were recruited as the research subjects and were divided into the Hp infection group with 29 cases and the no Hp infection group with 61 cases according to the result of Hp test.The result of pathological diagnosis of gastric mucosal tissues,intestinal flora,gastric mucosal tissue miR-22,CagA,serum TRX-1 and PGⅡwere observed and compared between the two groups of patients.RESULTS The proportions of patients with chronic atrophic gastritis,inflammatory activity,moderate to severe inflammatory degree,lymphoid follicles formation and epithelial intestinal metaplasia were significantly higher in the Hp infection group than in the no Hp infection group(P<0.05).The colony counts of Escherichia coli,Lactobacillus and Bifidobacterium of the Hp infection group were significantly less than those of the no Hp infection group(P<0.05);the colony counts of Lactobacillus acidophilus of the Hp infection group were significantly more than those of the no Hp infection group(P<0.05).The gastric mucosal tissue miR-22 level of the Hp infection group was significantly lower than that of the no Hp infection group(P<0.05);the levels of gastric mucosal tissue CagA,serum TRX-1 and PGⅡof the Hp infection group were significantly higher than those of the no Hp infection group(P<0.05).The area under curve(AUC)of the joint detection of gastric mucosal tissue miR-22,CagA,serum TRX-1 and PGⅡwas 0.940 in diagnosis of Hp infection in the patients with chronic gastritis,with the sensitivity 96.55%,the specificity 80.33%.CONCLUSION The Hp infection is associated with the progression of illness condition of the patients with chronic gastritis,it can lead to the disorder of intestinal flora.The chronic gastritis patients with Hp infection show low expression of gastric mucosal tissue miR-22 and high expressions of CagA,serum TRX-1 and PGⅡ.