HP和CagA^＋HP与中国人慢性萎缩性胃炎、胃腺癌、消化性溃疡的关系

目的　探讨幽门螺旋杆菌 (HP)及产细胞毒素型幽门螺旋杆菌 (CagA+HP)在中国人慢性萎缩性胃炎、胃腺癌、十二指肠球部溃疡及胃溃疡患者中的感染情况及意义。方法　将 492例患者分为 5组进行观察。无症状对照组 (AC组 )、慢性萎缩性胃炎组 (CAG组 )、胃腺癌组 (GCa组 )、十二指肠球部溃疡组 (DU组 )及胃溃疡组 (GU组 ) ,分别计算各组HP及CagA+HP的感染率以及患者中CagA+HP占HP感染的比例 (CagA+HP/HP) ,并作组间比较。结果　HP感染率在CAG及GCa组略高于AC组 ,但无统计学意义 ,DU及GU组HP感染率明显高于AC组 (P <0 .0 1;CagA+HP感染率及 (CagA+HP/HP) ] ,各相关疾病观察组均显著高于AC组的 2 4.2 %及 33 .8% (P <0 .0 1)。结论　HP相关性疾病如慢性萎缩性胃炎、胃腺癌及消化性溃疡时 ,以CagA+HP感染为主 ,CagA+HP感染率较无症状对照组更高 ,显然 ,在各相关性疾病的发生中CagA+HP占有极其重要的地位 ,这为疾病的防治乃至HP根治提供了重要的证据。

Relationship between HP,CagA~+HP and chronic atrophic gastritis,gastric adenocarcinoma, peptic ulcer

Objective　To investigate the roles of Helicobacter pylori(HP) and CagA positive Helicobacter pylori (CagA＋HP) in the pathogenesis of chronic atrophic gastritis (CAG),gastric adenocarcinoma (GCa),duodenal ulcer(DU )and gastric ulcer(GU).Methods　The 492 subjects were divided into five groups：group asymptomatic control(group AC),group CAG, group GCa, group DU and group GU. The infected rates of HP and CagA＋HP and the ratio of the number of CagA＋HP infected patients to that of HP (CagA＋HP/HP) were measured respectively.Comparison was done between different groups.Results　Compared with group AC, the infected rates of HP in group DU and GU were significantly high(P<0.01)，while no significant differences existed in group CAG or GCa.The infectied rates of CagA+HP in all groups of HP related diseases were significantly higher than that in group AC(P<0.01)，and so it was to CagA＋HP/HP.Conclusions　CagA＋HP may play the most important role in the pathogenesis of HP associated diseases，and it may be a valuable sign for HP eradication and for the treatment and precaution of HP associated diseases.