幽门螺杆菌相关性胃肠粘膜病患儿血清CagA抗体、VacA抗体检测及其临床意义

为了解幽门螺杆菌（elicobacter pylori,H.pylori)相关性胃肠粘膜病患儿血清中细胞毒素相关基因抗原（CagA)、空泡毒素抗原（VasA)的有无及其临床意义，应用免疫印迹法对46例慢性胃炎和25例消化性溃疡患儿血清CagA抗体、VacA抗体进行了检测。结果：（1）慢性胃炎小儿血清H.Pylori CagA抗体（＋）、VacA抗体（＋）检出率为28．3％，消化性溃疡患儿为64．0％，两组比较差异有显著性（P＜0．05）；（2）对慢性胃炎炎症活动程度进行分组检测，中、重度急性活动性胃炎患儿中H.Pylori CagA抗体（＋）、VacA抗体（＋）检出率为50．0％，与轻症者比较差异有显著性（P＜0．05）。提示H.pylori菌株存在不同致病能力，CagA、VasA是致小儿H.Pylori相关性胃肠粘膜病重要的毒力因素；通过检测CagA、VacA抗体，可及时指导临床治疗。

Determination of the serum Cellular toxin-associated gene and Vasical toxin-associated antibodies in children with Helicobacter pylori related gastro- intestinal mucosa disease and its clinical significance

Helicobacter pylori( H. Pylori) is one of the pivotal etiologic factors in the development of chronic gastritis and peptic ulcer in recent years. Many foreign investigators have discovered that some strains of H. pylori had cellular toxin - associated protein genes and vasical toxin genes. The products expressed by these 2 genes included the cellular toxin-associated gene antigen(CagA)and vasical toxin-associated antigen (VacA)which might have relation to the types of the gastro-intestinal diseases and the degree of the gastro-intestinal mucosa injury. In order to investigate whether there existed CagA and VacA in the serum obtained from the children with H. pylori associated gastro-intestinal mucosa diseases and their clinical significance, the immune imprint method has been used in 46 children with chronic gastritis(26 boys and 20 girls, their mean age was 6. 8 years old) and 25 children with peptic ulcer (12 boys and 13 girls, their mean age was 11.2 years old ) .After measuring the CagA antibody and VacA antibody in serum from these patients, the results indicated: (1) the positive rate of CagA antibody and VacA antibody was 28. 3% for the children with chronic gastritis and 50% for children with peptic ulcer, Showing significant difference between these two groups. (2) the positive rate of H.pylori CagA antibody and VacA antibody was 50% with significant difference in children with moderate and severe degree of acute activated gastritis compared with the mild degree of this diseases, suggesting that different strains of H. pylori have their own pathogenicity.CagA and VacA are two important toxic factors for H. pylori related gastro - intestinal mucosa diseases in children. So determination of CagA and VacA antibodies can be applied to guide the clinical treatment timely.