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目的:探讨基因芯片检测对幽门螺杆菌(H.pylori)感染的诊断价值及H.pylori致病毒力因子抗体与疾病病理严重程度的关系.方法:对2007-10/2008-04具有腹痛,呕吐,呕血,黑便等消化系统症状的30例患儿经13C呼气试验等方法进行H.pylori检测,对阳性的患儿做血清基因芯片检测,对基因芯片的检测方法进行敏感性、特异性分析;对两种方法均诊断H.pylori感染的病例行胃镜检查,观察镜下病变情况及组织病理改变,评估H.pylori毒力因子抗体与胃镜下表现及组织学严重程度的相关性.统计学分析采用诊断一致性分析Kappa检验.结果:血清学基因芯片毒力因子抗体检测与13C呼气试验等检测方法比较,敏感性为93.7%,特异性为60.0%,漏诊率为6.3%,总的符合率89.1%,显示较好的一致性.说明基因芯片检测对H.pylori感染的诊断具有一定的价值.H.pylori致病因子抗体谱中,抗CagA阳性的患者,对应的疾病有胃炎,消化性溃疡,过敏性紫癜腹型等.抗体谱最常见的是抗CagA阳性的表达,说明与抗原决定簇有关,而对应疾病病理较重时会有抗VacA阳性的表达.结论:基因芯片法检测H.pylori感染,具有特异性高,敏感性强的优点;同时能显示5种H.pylori毒力因子抗体,对了解H.pylori与疾病相关性、与疾病的严重程度关系及其指导用药均具有一定的意义.
Objective: To investigate the diagnostic value of microarray detection for H.pylori infection and the relationship between the virulence factor of H.pylori virulence and the severity of disease.Methods: Vomiting, hematemesis, melena and other digestive system symptoms of 30 cases of children by 13C breath test methods such as H.pylori detection of positive children do serum gene chip detection of gene chip detection sensitivity, specificity The gastroscopy was performed on the cases diagnosed as H.pylori infection by both methods. The pathological changes of the H.pylori infection were observed and histopathological changes were observed. The correlation between the H.pylori virulence antibody and the endoscopy and severity of histology was evaluated. Statistical analysis using diagnostic consistency analysis Kappa test.Results: Serological microarray virulence factor antibody detection and 13C breath test and other detection methods, the sensitivity was 93.7%, the specificity was 60.0%, the rate of missed diagnosis was 6.3% The overall coincidence rate of 89.1%, showing good consistency. That gene chip detection of H.pylori infection diagnosis has a certain value.H.pylori causative factor antibody spectrum, anti-CagA-positive patients, the corresponding diseases are Gastritis, elimination Ulcer, allergic purpura abdomen, etc .. The most common anti-CagA antibody expression is anti-CagA, indicating antigen-related determinants, and the corresponding disease pathology will have anti-VacA positive expression.Conclusion: Gene chip method Detection of H.pylori infection, with high specificity and sensitivity of the advantages; at the same time be able to display five kinds of H.pylori virulence factor antibodies, to understand the relationship between H.pylori and disease, the severity of the disease and its guidance All have a certain meaning.