幽门螺杆菌感染的免疫预防

幽门螺杆菌(H.pylori)已被确认为慢性活动性胃炎和消化性溃疡的重要致病菌,并与胃腺癌和胃黏膜相关淋巴组织(MALT)淋巴瘤的形成密切相关。H.pylori的免疫预防研究始于20世纪90年代初。1991年,Czinn等[1]首次进行了H.pylori 疫预防方面的动物实验,结果证明H.pylori 免疫预     

幽门螺杆菌长期感染对胃粘膜的影响

目的为了研究Hp长期感染对胃粘膜病变转归的影响.方法随防了63例10年前Hp感染患者,并分析对比10年前后Hp感染情况、胃镜和病理组织学变化.结果①63例患者中16例(25.4%)Hp转阴,47例(74.6%)Hp持续阳性.②Hp持续阳性者10年前后消化性溃疡(PU)的发生率分别为14例(29.78%)和25例(53.19%)(P＜0.05),Hp转阴者10年前后消化性溃疡(PU)的发生率分别为11例(68.8%)和2例(12.5%)(P＜0.05).③Hp持续阳性者10年前后慢性炎症严重程度积分分别为1.77±0.43和2.13±0.34(P＜0.01),肠上皮化生(IM)严重程度积分分别为1.13±0.35和1.63±0.52(P＜0.05);Hp转阴者10年前后慢性炎症严重程度积分分别为1.81±0.40和1.31±0.48(P＜0.01),肠上皮化生(IM)严重程度积分分别为1.6±0.55和1.4±0.59(P＞0.05);Hp持续阳性者10年前后胃粘膜糜烂的发生分别为8例(17.02%)和18例(38.29%)(P＜0.05),IM的发生分别为8例(17.02%)和21例(44.68%)(P＜0.01);Hp转阴者10年前后IM的发生均为5例(31.25%),胃粘膜糜烂10年后完全消失.结论Hp持续感染可增加消化性溃疡的发生机率,加剧胃粘膜的炎症程度,并促进肠化的形成和发展,根除Hp不仅能减轻胃粘膜的炎症程度,而且能阻止肠化的发生和发展.     

天津地区部分人群幽门螺杆菌感染现状

天津地区部分人群幽门螺杆菌感染现状刘之武李平谢蓓杨萍天津市公安医院内二科３０００５０主题词螺杆菌，幽门螺杆菌感染胃炎消化性溃疡Ｓｕｂｊｅｃｔｈｅａｄｉｎｇｓｈｅｌｉｃｏｂａｃｔｅｒ，ｐｙｌｏｒｉｈｅｌｉｃｏｂａｃｔｅｒｉｎｆｅｃｔｉｏｎｓｇａｓｔ...     

老年人消化性溃疡幽门螺杆菌感染的探讨

一、对象与方法１．对象：选择本院胃镜室从１９９６年６月至１９９８年１月经胃镜诊断的老年人十二指肠溃疡３２例、胃溃疡１９例、单纯性胃炎２３例,共７４例。其中男性４２例,女性３２例,年龄６０～７８岁,平均（６８．９±７．４）岁;非老年人十二指肠溃疡４４例...     

幽门螺杆菌感染对胃黏膜病理变化的影响

背景：幽门螺杆菌(H．pylori)感染已被公认为慢性胃炎和消化性溃疡的重要危险因素，根除H．pylori能加速消化性溃疡的愈合，但其对胃黏膜病理变化的影响尚有待进一步探索。目的：了解根除H．pylori对慢性胃炎胃黏膜病理变化和癌前状态的影响。方法：采用多中心随机对照临床试验和回顾性队列研究，样本选自胃癌高发区：上海郊区的金山区和奉贤区。共纳入360例经内镜检查证实有H．pylori感染的慢性胃炎伴或不伴十二指肠溃疡患者，随机分为两组。治疗组用三联疗法(质子泵抑制剂或Hz受体阻滞剂加两种抗生素)治疗，对照组单纯慢性胃炎患者予西沙必利、十二指肠溃疡患者予西米替丁治疗。在第1年和第4年末随访胃镜，根据H．pylori是否根除将患者分为两组：H．pylori阳性组和H．pylori阴性组。所有胃黏膜活检标本由两位病理科医师统一复读。结果：至第4年末，有120例患者完成全部随访，其中H．pylori持续根除组54例，阳转组5例；H．pylori持续未根除组45例，阴转组16例。持续根除组第1年随访时，活动性炎症比例减少(P＜O．05)；第4年随访时，慢性炎症和肠化程度以及活动性炎症比例减少(P＜O．05)。持续未根除组第1年随访时，慢性炎症程度增加(P＜O．05)；第4年随访时，慢性炎症和肠化程度以及活动性炎症比例增加(P＜O．05)，萎缩程度较第1年随访时增加(P＜O．05)。结论：根除H．pylori可以减轻慢性胃炎的炎症程度，防止肠化的发生和发展。     

雷,环,痢方案根治幽门螺杆菌感染临床疗效观察

目的 观察雷尼替丁,环丙沙星,痢特灵三联对幽门螺杆菌（Ｈｐ）阳笥的消化性溃疡,慢性胃炎患者的Ｈｐ根除率及对消化性溃疡的治疗效果。方法 经快速尿素酶试验及胃粘膜活检均确认Ｈｐ感染的消化性溃疡,慢性胃炎患者共１５５例,用雷尼替丁,环丙沙星,痢特灵三联与改良的经典三联（果胶铋,四环素,痢特灵）作随机对照治疗。     

泻心汤免煎剂治疗幽门螺杆菌感染的临床疗效

[目的] 观察泻心汤免煎剂治疗幽门螺杆菌(Hp)感染的临床疗效。[方法] 选择60 例慢性胃炎、消化性溃疡14C尿素呼气试验阳性者。采用泻心汤免煎剂治疗,疗程1周,观察治疗前后的疗效、Hp值。1 周疗程结束后再以其中14C尿素呼气试验Hp值阳性者40例随机分为4组,分别予服泻心汤免煎剂、单味中药大黄免煎剂、黄芩免煎剂和黄连免煎剂治疗,疗程1周,再观察Hp值。[结果] 泻心汤组治疗60例和后继治疗10 例,患者临床总有效率分别为76.7%和70 .0%,泻心汤治疗前后比较差异有统计学意义(P<0 .05);泻心汤与单味中药比较差异有统计学意义 P<0. 05);而单味中药之间差异无统计学意义(P>0. 05)。[结论] 泻心汤免煎剂具有抑制Hp的作用,其疗效优于单味大黄、黄连、黄芩;而单味中药黄连、黄芩、大黄之间疗效差异无统计意义。     

幽门螺杆菌的毒力研究

幽门螺杆菌（周位icr：nzczer八八加，HP是一种生长于胃粘膜表面与粘膜层之间的微需氧菌．自1983年Mhl．we－，－Wxxad首次从胃粘膜中分离出HP以来，大量研究表明该菌与慢性胃炎、消化性溃疡（PU）密切相关，与胃癌也有一定的关系．但人群中Hp感染率为50％，只有少数Hp感染患者发展为PU或胃炎，造成这种反应的差异有二个原因．一是n毒力的大小，二是人体的防御能力．最近研究了产生细胞毒素的HP菌株，比较和探讨了这方面的资料，为HP致病机制的研究开辟了新的途径．HP要侵及胃粘膜需有定植因子（maintenancefactors）和致病因子（po…     

重视幽门螺杆菌毒素的研究

重视幽门螺杆菌毒素的研究胡伏莲幽门螺杆菌（ＨｅｌｉｃｏｂａｃｔｅｒＰｙｌｏｒｉ，Ｈｐ）感染在世界上很普遍，大约超过一半的世界人口感染ＨＰ，虽然所有的Ｈｐ感染者组织学上都有胃炎的表现，但多数人并无症状，仅少部分人发展成消化性溃疡病与胃癌。为什么Ｈｐ感染...     

重视幽门螺杆菌感染处理中的临床问题

幽门螺杆菌(H.pylori,简称Hp)分离至今已26年,26年来Hp的研究得到迅速发展,人们对Hp的细菌学、流行病学、致病机制,不论从基础到临床,从细胞水平到分子机制都作了系统而深入的研究或探索.     

幽门螺杆菌基因特征与宿主临床结果相关性研究进展

幽门螺杆菌感染是全世界最常见的慢性感染，其致病机制涉及到菌体毒力因子、宿主及感染后引起的炎症与免疫反应等多方面因素。近年来，随着幽门螺杆菌全基因组测序的完成，幽门螺杆菌基斟多态性逐渐成为研究的热点。本文对幽门螺杆菌相关毒力基因cagA、vacA、各黏附基因、oipA、iceA及dupA基因结构多态性、编码蛋白功能的差异及其与宿主临床结果之间的相关性作一综述。     

Helicobacter pylori infection in obesity and its clinical outcome after bariatric surgery

The present review summarizes the prevalence and active clinical problems in obese patients with Helicobacter pylori(H.pylori)infection,as well as the outcomes after bariatric surgery in this patient population.The involvement of H.pylori in the pathophysiology of obesity is still debated.It may be that the infection is protective against obesity,because of the gastritis-induced decrease in production and secretion of the orexigenic hormone ghrelin.However,recent epidemiological studies have failed to show an association between H.pylori infection and reduced body mass index.H.pylori infection might represent a limiting factor in the access to bariatric bypass surgery,even if highquality evidence indicating the advantages of preoperative H.pylori screening and eradication is lacking.The clinical management of infection is complicated by the lower eradication rates with standard therapeutic regimens reported in obese patients than in the normalweight population.Prospective clinical studies to ameliorate both H.pylori eradication rates and control the clinical outcomes of H.pylori infection after different bariatric procedures are warranted.     

Clinical presentation in relation to diversity within the Helicobacter pylori cag pathogenicity island

OBJECTIVE: This study investigated the genetic diversity of the cag pathogenicity island (PAI) in Helicobacter pylori (H. pylori) in relation to clinical outcome and interleukin (IL)-8 production. METHODS: Seven genes in the cag PAI (cagA, cagE, cagG, cagM, cagT, open reading frame 13 and 10) were examined by polymerase chain reaction and Southern blot hybridization using H. pylori from 120 patients with different presentations (duodenal ulcer, gastric cancer, gastritis alone). IL-8 production from AGS cells (gastric cancer cell line) cocultured with H. pylori was measured by ELISA. RESULTS: An intact cag PAI was present in 104 (87%) isolates, and five (4%) had deletions within the cag PAI; 11 (9%) lacked the entire cag PAI. Clinical isolates containing the complete cag PAI induced a greater secretion of IL-8 as compared with those without the cag PAI (3048 +/- 263 vs 480 +/- 28 pg/ml, p < 0.001). Deletion of only cagG reduced IL-8 secretion by two thirds. Deletions of more than one locus reduced IL-8 secretion to background. A similar proportion of H. pylori from patients with gastritis, duodenal ulcer, or gastric cancer had intact cag PAI (88%, 88%, and 85%, respectively). Although the presence of cagG was a better predictor of the presence of an intact cag PAI than cagA or cagE, the presence or absence of any of these genes had no association with clinical presentation. CONCLUSION: Although the cag PAI plays an important role in IL-8 production, clinical presentation cannot be predicted by the presence of an intact cag PAI or any of these seven cag PAI genes.     

Epithelial attachment alters the outcome of Helicobacter pylori infection

Genetically defined in vivo models are needed to assess the importance of target cell attachment in bacterial pathogenesis. Gastric colonization by Helicobacter pylori in human populations is common and persistent, and has various outcomes including peptic ulcers and cancer. The impact of attachment on the course of infection was examined in transgenic mice expressing a human receptor for H. pylori in their gastric epithelium. Persistent infection by a clinical isolate occurred at comparable microbial densities in transgenic and nontransgenic littermates. However, microbial attachment in transgenic mice resulted in production of autoantibodies to Lewis^x carbohydrate epitopes shared by bacteria and acid-secreting parietal cells, chronic gastritis, and parietal cell loss. This model should help identify bacterial and host genes that produce attachment-related pathology.     

幽门螺杆菌临床检测研究进展

准确可靠的检测方法是诊断胃H pylori感染和评价临床疗效的关键。按检测取材方式的不同可分为侵入性和非侵入性,前者包括微生物学方法、形态学检查、尿素酶依赖性试验,而后者包括血清免疫学、基因分子生物学检测、粪便H pylori抗原检测等。     

Relationship between Helicobacter pylori hopQ genotype and clinical outcome in Asian and Western populations

Background and Aims:  Outer membrane proteins of Helicobacter pylori mediate important pathogen–host interactions such as colonization, adhesion and the inflammatory response. hopQ genotypes have been suggested to be associated with increased risk of peptic ulcer. The aim of this study was to test the relation of hopQ genotype to H. pylori -related disease and histological changes in Asian and Western countries.
Methods:  hopQ genotype, cagA status and vacA genotype of H. pylori isolated from patients from Asian and Western countries were determined and the results were compared with the clinical presentation and gastric histology.
Results:  Most Asian strains possessed virulent genotypes ( hopQ type I, vacA s1-m1 and cagA -positive). In Western countries, hopQ type I genotype was significantly linked with vacA s1 and m1 genotypes and cagA -positive status. Inflammatory cell infiltration and atrophy scores were significantly higher in patients with hopQ type I strains than those with type II in Western patients. However, the hopQ type I genotype was not associated with an increased risk for peptic ulcer or gastric cancer, and had no additive effects to vacA genotypes or cagA -positive status.
Conclusion:  The expression of multiple putative virulence factors in Asian strains likely explains the relatively high incidence of clinical outcomes including gastric cancer compared with other parts of the world. Although hopQ genotype did not improve the predictive value above other genotyping for development of H. pylori -related gastroduodenal diseases, the hopQ genotype might be able to add a useful virulence marker for gastroduodenal diseases.     

幽门螺杆菌的基础与临床研究

近年来陆续发现新的螺杆菌，迄今至少证实24种螺杆菌菌属，分布在一些动物体内。其中H．hepaficus为一已知的致癌原，H．bilis与肠道和肝胆疾病有关。在人的胃以外器官已发现一些螺杆菌，如在瑞典和爱沙尼亚的原发性胆汁性肝硬化、原发性硬化性胆管炎和肝细胞性肝癌病人中H．pullorum和H．hepaficus很常见.     

幽门螺杆菌的细菌学变迁及对临床用药的指导变化

幽门螺杆菌(H.pylori,简称Hp)的发现,在改变了对人类慢性活动性胃炎、消化性溃疡和胃癌发生机制认识的同时,也改变了Hp感染相关疾病(包括消化系统疾病和其他胃肠道外相关疾病)的治疗面貌,使大量的曾被认为是不易治愈的疾病随着Hp的根除而根治.