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目的 探讨幽门螺杆菌 (Hp)细胞毒素相关蛋白 (cagA)、空泡毒素 (vacA)与儿童胃十二指肠疾病类型及胃黏膜炎症程度的关系。方法 采用免疫印迹法测定 88例Hp相关性慢性胃炎 (CG)、4 6例Hp相关性消化性溃疡 (PU)患儿血清cagA、vacA抗体 ,并观察胃黏膜病理变化。 结果 1.CagA、vacA抗体总检出率分别为 85 .0 7%、91.0 4 % ,cagA抗体在CG与PU中检出率分别为 84 .0 9%与 86 .96 % ,两组相比无显著性差异 (P>0 .0 5 ) ;vacA抗体在CG与PU中检出率分别为 89.77%与 93.4 8% ,两组相比无显著性差异 (P >0 .0 5 )。 2 .134例Hp感染患儿cagA、vacA抗体均阳性 (Ⅰ型菌 ) 113例 ,cagA、vacA抗体均阴性 (Ⅱ型菌 ) 11例 ,cagA、vacA抗体仅一项阳性 (中间型 ) 10例 ,各型菌株在CG、PU中的检出率无明显差异 (P均 >0 .0 5 )。 3.113例Hp Ⅰ型菌株感染引起胃黏膜中重度炎症占 88.5 0 % ,而Ⅱ型菌株、中间型菌株感染引起胃黏膜中重度炎症分别为 4 5 .4 5 %及 5 0 .0 0 % ,两组有显著性差异 (P <0 .0 1)。结论 CagA、vacA与CG、PU发病均有关 ,不能作为区分Hp感染致不同胃十二指肠疾病的特异性指标。本地区儿童感染的Hp主要为cagA和vacA阳性的Ⅰ型菌株 ,能引起胃黏膜较重的炎症
Objective To investigate the relationship between Helicobacter pylori (Hp) cytotoxin-associated protein (cagA), vacuolar vacuole (vacA) and gastroduodenal diseases in children and the degree of gastric mucosal inflammation. Methods Serum cagA and vacA antibodies in 88 children with Hp-associated chronic gastritis (CG) and 46 children with Hp-associated peptic ulcer (PU) were detected by immunoblotting. The pathological changes of gastric mucosa were observed. The total detection rates of CagA and vacA were 85.0% and 91.0% respectively. The detection rates of cagA antibody in CG and PU were 84.0% and 86.96% (P> 0.05). The detection rates of vacA antibody in CG and PU were 89.77% and 93.48% respectively, there was no significant difference between the two groups (P> 0.05). Among 113 cases of Hp infection, 113 cases were positive for cagA and vacA antibodies (type Ⅰ), 11 cases were negative for cagA and vacA (type Ⅱ) and 10 cases were positive for cagA and vacA (middle type) There was no significant difference in the detection rate of each type of strain between CG and PU (P> 0.05). 3.113 cases of Hp type Ⅰ infection caused severe inflammation in gastric mucosa accounted for 88.5%, while type Ⅱ strains and intermediate strains caused severe inflammation in gastric mucosa were 45.54% and 50.0%, respectively, two There was a significant difference between the two groups (P <0.01). Conclusions CagA, vacA are related to the pathogenesis of CG and PU, and can not be used as a specific index for distinguishing between different gastroduodenal diseases caused by Hp infection. Hp infection in children in this region mainly cagA and vacA positive type I strains can cause severe gastric mucosal inflammation