幽门螺杆菌根除前后血清抗体滴度变化的临床意义

目的探讨幽门螺杆菌（Hp）血清抗体细胞毒素相关蛋白A（CagA）、尿素酶（Ure）滴度的变化在Hp根除疗效中的临床意义。方法采用经胃镜及快速尿素酶试验确诊为Hp相关性消化性溃疡患者118例,以蛋白芯片方法检测血清CagA、Ure抗体,观察其根除前、根除后8周、24周抗体滴度变化。结果118例患者有102例Hp根除,根除率为86.4%。根除治疗成功组在治疗后8周CagA、Ure抗体滴度下降无显著性,24周后则显著下降（P〈0.05）,下降幅度分别为63.5%、41.3%,CagA及Ure抗体的下降幅度比较差异有统计学意义（P〈0.05）。而根除治疗失败组的CagA、Ure抗体滴度无明显变化（P〉0.05）。结论蛋白芯片法动态观察血清CagA、Ure抗体水平8～24周以上,可作为评估根除Hp疗效的一种参考方法,且CagA抗体可能更有意义。

The change of specific serum antibodies titers in Helicobacter pylori eradication therapy

Objective To explore the changes of serum antibodies titers against Cytotoxin associated protein A （CagA） and Urease （Ure）,and their significances in the diagnosis of Helicobacter pylori （Hp） eradication.Methods 118 patients with peptic ulcer associated with Hp,who were diagnosed by gastroscopy and rapid Ure test,were enrolled in the study.Two kinds of Hp antibodies against CagA and Ure were detected with the technology of protein chip. The changes of antibodies titers were observed before therapy,at 8 weeks and at 24 weeks after therapy.Results Eradication rate of Hp was 86.4% （102/118）. In the successful eradication group,the titers of anti-CagA and anti-Ure were decreased slightly at 8 weeks and significantly at 24 weeks （P〈0.05）;the decreasing ratios of two antibodies were 63.5% and 41.3%,respectively,and the decreasing ratio of anti-CagA was significantly higher than one of anti-Ure （P〈0.05）. In the false eradication group,no significant difference was found in the titers of anti-CagA and anti-Ure from pre-therapy to 24 weeks after therapy （P〉0.05）.Conclusions The change of titers of anti-CagA and anti-Ure measured by the method of protein chip at 8-24 weeks after therapy may be used to evaluate the effect to eradicate Hp,and anti-CagA antibody perhaps plays a more important role.