应用免疫印迹法探讨血清幽门螺杆菌抗体谱与上消化道疾病的关系

目的：用免疫印迹法检测幽门螺杆菌（Hp）感染中不同血清分型与慢性浅表性胃炎（CSG）、慢性萎缩性胃炎（CAG）、消化性溃疡（PU）和胃癌（GC）的关系。方法：选取确诊为Hp感染的上消化道疾病患者205例，用Western blot法（免疫印迹法）测血清幽门螺杆菌抗体谱，检测Hp抗体分型，分析CagA和/或VacA抗体阳性的表达情况。结果：在Hp现症感染中，CSG、CAG、PU、GC患者的HpⅠ型感染比例明显高于Ⅱ型感染（P〈0.01）；PU及GC中HpⅠ型感染率高于CSG（P〈0.05）。不同年龄段及不同性别中HpⅠ型感染比例均高于Ⅱ型感染（P〈0.01）。各组的Hp I型感染者中以CagA＋VacA抗体为主，检出率为77.4%；其中以CSG组最低（70.4%）、GC组最高（81.8%）。各组CagA＋VacA抗体检出率显著高于单一CagA/VacA抗体检出率（P〈0.01）。结论：应用免疫印迹法进行幽门螺杆菌血清学分型检测对于上消化道疾病的判断有临床指导意义，Ⅰ型Hp感染更需要进行根治。

Discussion of the Relationship between the Serum Helicobacter Pylori Antibody Spectrum and the Disease of Upper Digestive Tract Using Western Blot

Objective：To detect the relationship between the different serotype of Helic-obacter pylori infection among the disease of the chronic superficial gastritis,chronic atrophic gastritis,peptic ulcer and gastric cancer using the Western blot.Method：205 patients with upper gastrointestinal diseases who diagnosed Hp infection were selected, the helicobacter pylori antibody spectrum was detected by the Western blot,the positive expression of the CagA and/or VacA antibody were analyzed.Result：Among the patients with Hp infection,the infection ratio of HpⅠamong the disease of CSG,CAG,PU,GC were obviously higher than Hp Ⅱ（P〈0.01）;Hp Ⅰinfection ratio in PU,GC were higher than in CSG（P〈0.05）. HpⅠtype infection in the different age groups and different gender ratio were higher than typeⅡinfection（P〈0.01）. The CagA＋VacA antibodies was priority in the HpI type of each groups,the detection rate was 77.4%;the CSG group was the lowest（70.4%）,the GC group was the highest（81.8%）. CagA＋VacA antibody detection rate of each groups was significantly higher than that of single CagA/VacA antibody detection rate（P〈0.01）. Conclusion：It is significance in clinical to use the Western blot to detect the different serotype of Helicobacter pylori in diagnoses the disease of upper digestive tract. HPⅠinfection should be cured for more reasons.