免疫印迹试验在诊断儿童幽门螺旋杆菌感染中的应用评价

目的:评价免疫印迹试验(WesternBlotting)在诊断不同年龄组及不同病理表现儿童幽门螺旋杆菌(Helicobacterpylori,HP)感染中的应用价值。方法:对450例有消化道症状的患儿,进行胃镜检查并取病变处胃黏膜组织行病理学检查,以及13C尿素呼气试验(13Cureabreathtest,13CUBT)、血清免疫印迹试验及胃液HPDNAPCR检查。结果:在4岁～6岁和6岁～12岁组患儿中,13CUBTHP检出率明显高于免疫印迹试验(P<0.01);在12岁～18岁组患儿中,13CUBTHP检出率与免疫印迹试验比较差异无显著性(P>0.05)。细胞毒性基因相关蛋白(Cytotoxinassociatedgeneprotein)阳性的HP感染在溃疡病组明显高于慢性胃炎组和正常组(P<0.05),慢性胃炎组CagA(Cytotoxinassociatedgeneprotein,CagA)阳性HP显著高与正常组(P<0.05)。结论:在12岁以上的少年患儿中,免疫印迹试验可作为快速诊断HP感染的可靠手段,并且能判断出是否为产毒菌株感染。在12岁以下的儿童中,免疫印迹试验最好与13CUBT联合使用。

The Evaluation of Western Blotting Method for the Diagnosis of Helicobacter Pylori Infection in Children

Objective To evaluate the accuracy of the Western Blotting test in the diagnosis of Helicobacter pylori(HP) in different age groups with various gastric illnesses in children.Methods 450 children with digestive tract symptoms were tested for HP using pathological histology, 13C-UBT,serum western blotting and HP-DNA-PCR.Results In the groups with ages from 4 to 6 and 6 to12 years the detection frequency using 13C-UBT were significantly higher than Western blotting (P<0.01).In the group with ages from 12 to 18 years,there was no difference between 13C-UBT and Western Blotting in detection(P>0.05).Positive rate of Cag A antibody in peptic ulcer group was significantly higher than that of chronic gastritis group (P<0.05),Positive rate of Cag A antibody in chronic gastritis group was significantly higher than that of normal control group (P<0.05).Conclusion It is rapid and dependable that the Western Blotting can be used to examine the HP antibodies in children with ages above twelve years and to determine the type of HP.