幽门螺杆菌免疫分型诊断上消化道疾病的临床分析

目的探讨幽门螺杆菌（helicobacter pylori，Hp）分型在上消化道疾病中的应用价值。方法比较免疫印迹法，^14C-尿素呼气试验及快速尿素酶试验检测172例慢性上消化道疾病患者Hp感染阳性检出率；应用免疫印迹法观察不同类型Hp感染在慢性上消化道疾病中的分布频数。结果免疫印迹法、^14C-尿素呼气试验及快速尿素酶试验Hp阳性检出率分别为69．8％、71．2％、65．1％，三者相比差异无统计学意义。Ⅰ型Hp感染者中胃炎、消化性溃疡和胃癌的构成比显著高于Ⅱ型；Ⅰ型Hp在胃癌及消化性溃疡中的表达率显著高于慢性胃炎。结论应用免疫印迹法进行Hp抗体分型发现HpⅠ型菌株比Ⅱ型菌株更有可能增加胃癌及消化性溃疡的发生风险，因此HpⅠ型感染者可能更有治疗价值。

Clinical Value of Immunological Classification of Helicobacter Pylori in Patients with Upper Gastrointestinal Diseases

Objective To evaluate the clinical value of immunological classification of helicobacter pylori（Hp） in patients with upper gastrointestinal diseases （UGD）. Methods Hp positive rate was calculated in 172 patients with UGD by immunological classification,^14C-urea breath test （^14C-UBT） and rapid urease test （RUT）. Patients with present Hp infection were serotyped as type Ⅰ and type Ⅱ by immunoblot technique. The percentages of chronic gastritis （ CG）, peptic ulcers （ PU ） and gastric cancer （GC）in patients with Hp type Ⅰ or type Ⅱ were investigated respectively. Results The positive rate of Hp infection by the method of immunoblot, ^14C-UBTand RUT was 69.8% ,71.2% and 65.1% respectively ,the difference was insignificant. The percentages of GC, PU and GC in patients with type Ⅰ Hp infection were significantly higher than that in patients with type Ⅱ Hp infection. The infectious rates of type Ⅰ strain in group GC and PU were significantly higher than that in group CG. Conclusions Hp immunoblot is a helpful method for evaluating the severity of chronic UGD caused by Hp infectious. It is necessary to treat type I Hp infection.