CAJ | 학술논문

目的研究十二指肠球部溃疡患者中Hp的表型特征及其亚型,并评价Hp表型分型在十二指肠球部溃疡患者中的临床意义.方法用免疫印迹法检测135例十二指肠球部溃疡(研究组)及140例慢性浅表性胃炎(对照组)患者血清中细胞毒素相关蛋白A(CagA)抗体、空泡细胞毒素A(VacA)抗体和尿素酶(UreA、UreB)抗体及其亚型.结果研究组患者中,中间型Hp感染率为21.5%,明显低于对照组患者的27.9%,P<0.05.VacA抗体和CagA抗体均可单独表达.Hp表型表达与Hp各亚型表达之间,CagA和VacA抗体在两组间比较差异无统计学意义,P>0.05,但尿素酶抗体在研究组患者中的表达率明显高于对照组患者,P<0.05.I型Hp中尿素酶30ku亚基在研究组患者中的表达率(45.5%)亦明显高于对照组患者(33.3%),P<0.05.结论 CagA的表达不依赖于VaeA的表达.Hp多种亚型如128ku CacA、116ku CagA、95ku VaeA、91ku VneA、30ku UreA同时表达在致十二指肠球部溃疡中起综合作用.I型Hp且同时表达30 ku UreA的菌株可能有更强的毒力且更易致十二指肠球部溃疡.
목적 연구십이지장구부궤양환자중Hp적표형특정급기아형,병평개Hp표형분형재십이지장구부궤양환자중적림상의의.방법 용면역인적법검측135례십이지장구부궤양(연구조)급140례만성천표성위염(대조조)환자혈청중세포독소상관단백A(CagA)항체、공포세포독소A(VacA)항체화뇨소매(UreA、UreB)항체급기아형.결과연구조환자중,중간형Hp감염솔위21.5%,명현저우대조조환자적27.9%,P<0.05.VacA항체화CagA항체균가단독표체.Hp표형표체여Hp각아형표체지간,CagA화VacA항체재량조간비교차이무통계학의의,P>0.05,단뇨소매항체재연구조환자중적표체솔명현고우대조조환자,P<0.05.I형Hp중뇨소매30ku아기재연구조환자중적표체솔(45.5%)역명현고우대조조환자(33.3%),P<0.05.결론 CagA적표체불의뢰우VaeA적표체.Hp다충아형여128ku CacA、116ku CagA、95ku VaeA、91ku VneA、30ku UreA동시표체재치십이지장구부궤양중기종합작용.I형Hp차동시표체30 ku UreA적균주가능유경강적독력차경역치십이지장구부궤양.
Objective to study the characteristic typing of Helicobacter pylor(Hp)phenotypes and their sub-phenotypes in the patients with duodenal bulb ulcers(DU),and its clinical significance. Methods One hundred thirty-five cases with DU and 140 casses with chronic superficial gastritis were enrolled in this study. Determinations of serum cytotoxin-associated gene protein A (CagA),vacuolating cyto-toxin A(VacA),urease (Ure)A,UreB antibodies and their sub-phenotypes by immunoblotting were carried ou. Results Positive rate of middle-phenotypes of Hp infection in DU was significantly lower than that in chronic superficial gastritis (21.5%vs 27.9%,P<0.05).VacA and CagA antibodies might express alone. There had no significant difference among the expression rate of phenotype CagA, VacA antibodies and their sub-phenotype. But expression rate of Ure antibodies in Du was higher than that in chronic superficial gasstritis (P<0.05).In infection of Hp type I, the expression rate of sub-phenotypes 30ku UreA in DU was hronic superficial gastritis (P<0.05). Conclusions The VacA is not for expressing higher than that inpression of Hp exists many sub-phenotypes ( 128 ku CagA 116 ku CagA, 95 ku VacA, 91 ku CagA 0 ku UreA),and it probably causes formation of DU by comprehensive effect. Hp type I with sub phenotype expressing 30 ku Urea may be more pathogenic in DU formation.