幽门螺杆菌感染及其毒力因子和胃十二指肠疾病关系的研究

目的 探讨幽门螺杆菌（Hp)感染病人中Hp细胞毒相关蛋白（CagA)、细胞空泡毒素（VacA)抗体在胃十二指肠疾病的比例，并评估不同类型幽门螺杆菌感染对胃窦粘膜炎症程度的影响。方法 应用免疫印迹法测定Hp感染者病人体内的CagA、VacA抗体。结果 73％的Hp感染者病人中出现CagA抗体，61％Hp感染者病人中出现VacA抗体。CagA抗体和VacA抗体在各疾病之间差异无显著性（P＞0．05）。在胃溃疡、十二指肠溃疡和复合性溃疡三类病人中，具CagA和VacA双阳性的比例较CagA和VacA双阴性的比例差异有显著性（P＜0．05）。胃窦萎缩病变在CagA和VacA双阳性的病人中比CagA和VacA双阴性的病人严重（P＜0．05）。结论 具有高毒力因子（CagA和VacA)的Hp是胃肠疾病病人感染的常见菌株，具有CagA和VacA的Hp可能在诱导胃粘膜发展到萎缩病变过程中起重要作用。但不能作为特异性指标来判断胃十二指肠疾病。

Factors of Helicobacter pylori and their relationship with gastroduodenal disease

Objective To assess the relation between cytotoxin associated gene A(CagA) and vacuolating cytotoxin gene A(VacA) of Helicobacter pylori with gastroduodenal disease. Methods The immunoblot assay was used to detect serum antibodies against CagA and VacA obtained from the patients infected by H.pylori The severity and activity of inflammation in the antrium were evaluated and compared with Hp status. Results Serum antibodies to CagA and VacA were detected in 73% and 61% of the patients infected by H.pylroi respectively. The difference was not statistically significant( P >0.05). Gastric atrophy was significantly more common in CagA positive and VacA positive patients than both CagA and VacA negative patients( P <0.05). Conclusion The high seroprevalence of the CagA and VacA positive H.pylori strains is common in the patients with gastroduodenal disease. But they are not specific markers for the gastroduodenal disease. Both CagA and VacA positive strain of H.pylori may be the important factor in inducing gastric histological changes which may evolve into gastric atrophy.