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目的 研究幽门螺杆菌vacA基因型、cagA基因 ,空泡形成细胞毒素和血清CagA抗体与胃十二指肠疾病的关系。 方法 应用多聚酶链反应方法对 6 2例慢性胃炎、消化性溃疡和胃癌患者分离获得幽门螺杆菌菌株的vacA基因型和cagA基因进行测定 ;应用Hela细胞方法测定体外空泡形成细胞毒素活性 ;应用酶免疫测定方法检测同一患者的血清CagA抗体。结果 6 2株幽门螺杆菌菌株均具有vacA基因 ,所有菌株的vacA基因型均为sla/m2型。cagA基因的总阳性率为5 6 4 5 % ;慢性胃炎、消化性溃疡和胃癌患者分离获得幽门螺杆菌的cagA基因阳性率分别为 5 5 5 6 %、5 4 17%和6 3 6 4 % (P >0 0 5 )。空泡形成细胞毒素的阳性率为 37 10 % ,慢性胃炎、消化性溃疡和胃癌患者分离获得幽门螺杆菌菌株表达空泡形成细胞毒素的阳性率分别为 33 33%、2 9 17%和 6 3 6 4 % (P >0 0 5 )。慢性胃炎、消化性溃疡和胃癌患者血清CagA抗体分别为 70 37%、79 17%和 4 0 0 0 % (P >0 0 5 ) ,血清CagA抗体的总阳性率为 6 8 85 %。结论 幽门螺杆菌vacA基因型、cagA基因、空泡形成细胞毒素和血清CagA抗体不能预示H pylori感染个体将更可能发生何种类型胃十二指肠疾病。
Objective To study the relationship between vacA genotypes of Helicobacter pylori, cagA gene, vacuolization-forming cytotoxin and serum CagA antibody and gastroduodenal diseases. Methods The genotypes of vacA and cagA of Helicobacter pylori isolated from 62 patients with chronic gastritis, peptic ulcer and gastric cancer were determined by polymerase chain reaction method. The cytotoxic activity of vacuolar cells was measured by Hela cell method. Immunoassay method to detect the same patient serum CagA antibody. Results There were vacA genes in all of the 62 Helicobacter pylori isolates. The vacA genotypes of all isolates were all sla / m2. The positive rate of cagA gene was 56.4%. The positive rates of cagA gene isolated from patients with chronic gastritis, peptic ulcer and gastric cancer were 55.6%, 54.17% and 63.64%, respectively (P> 0 0 5). The positive rate of vacuolar formation of cytotoxin was 37 10%. The positive rates of vacuolar formation of cytotoxins isolated from Helicobacter pylori isolates from patients with chronic gastritis, peptic ulcer and gastric cancer were 33 33%, 29 17% and 63 6 4% (P> 0 0 5). The serum levels of CagA antibodies in patients with chronic gastritis, peptic ulcer and gastric cancer were 70 37%, 79 17% and 400% respectively (P 0 05), and the total positive rate of CagA antibody in serum was 68 85%. Conclusion The H. pylori vacA genotype, cagA gene, vacuolar cytotoxicity and serum CagA antibody do not predict what type of gastroduodenal disease will be more likely to occur in H pylori-infected individuals.