PCR技术在儿童幽门螺杆菌感染中的应用

目的 建立一套适合儿童幽门螺杆菌感染的PCR检查方法，了解儿童幽门螺杆菌感染的可能途径。方法 对37例4～14岁患儿采用聚合酶链反应检测胃粘膜、胃液和唾液中的幽门螺杆菌，并作胃粘膜快速尿素酶、病理W—S银染色及细菌培养。结果 37例患儿中尿毒酶、病理W—S银染色、细菌培养、胃粘膜PCR、胃液PCR和唾液PCR的检出率分别为35．14％、40．54％、35．14％、45．95％、35．14％和5．40％；敏感性为68．8％、81．2％、81.3％、93．8％、81.3％、12．5％；特异性为90．5％、90．5％、100％、90．5％、100％、100％；2项或2项以上检出率阳性判断为幽门螺杆菌感染，37例患儿中阳性16例。结论 胃粘膜、胃液PCR方法同其他幽门螺杆菌检测手段相比幽门螺杆菌阳性检出率相似，PCR方法具有操作简便，特异性、敏感性高的优点，是诊断儿童幽门螺杆菌感染、判断药物疗效的有效检查手段。唾液PCR阳性率低可能与口腔缺乏特定的幽门螺杆菌生长环境有关，但也提示口-口传播是幽门螺杆菌感染的可能途径。

Detection of H.pylori in gastric mucosa, gastric juice and saliva in children with polymerase chain reaction

Objective To establish a PCR method suitable for the detection of H.pylori infection in children and find a possible transmission way of Hp infection,to make a better diagnosis and treatment for H.pylori infection.Methods Thirty- seven children between 4 and 14 years (20 boys and 17 girls)were enrolled.The specimen from gastric mucosa,gastric juice and saliva were detected to find H.pylori infection with PCR.Primer of PCR used in this study was urase C.The specimen of gastric mucosa was treated with the method of rapid urase,within- starry stains,and bacterial culture was also performed.Results The results showed that H.pylori detection rate of rapid urase,wathin-starry stains,bacterial culture,gastric mucosa,gastric juice and salive PCR were 35.14%,40.54%,35.14%,45.95%,35.14%,and 5.40% respectively.Sensitivity were 68.8%,81.2%,81.3%,93.8%,81.3%,and 12.5% separately.The specificity were 90.5%,90.5%,100%,90.5%,100%,and 100%.Positive prognosticate rate were 84.6%,86.7%,100%,88.2%,100%,and 100%.Negative prognosticate rate were 79.2%,90.5%,87.5%,95.0%,87.5%,and 58.3% independently.The H.pylori infection was confirmed if two or more items were positive.16 of 37 cases were confirmed as positive.Conclusions Gastric mucosa,gastric juice PCR methods were effective for detecting H.pylori infection and estimating efficacy of treatment with simple operation,high specificity and sensitivity in comparison with other methods. The oral- oral transmission way might be a possible infectious way of H.pylori infection.