CAJ | 학술논문

目的：探讨幽门螺杆菌（H P ）感染相关胃炎程度与胃黏膜细胞凋亡基因表达的相关性。方法将2013年11～12月大坪医院消化内镜中心45例慢性胃炎患者纳入研究，快速尿素酶实验和13 C-呼气实验检测H P感染情况，病理分析H P感染部位胃炎严重程度，实时定量PCR （qRT-PCR）法检测HP感染部位胃黏膜组织和无 HP感染的胃黏膜组织中凋亡相关基因Bax、Bak、Bcl-2的表达，Person相关分析 HP感染的慢性胃炎程度与凋亡基因表达的相关性。结果45例患者13 C-呼气实验和胃窦黏膜快速尿素酶实验均阳性，提示H P感染。病理结果显示45例（100％）患者均为慢性胃窦胃炎，其中28例（62．2％）为轻度，16例（35．6％）为中度，1例（2．0％）为重度；9例（20．0％）肠化生，5例（11．1％）低级别上皮内瘤变。45例患者胃体黏膜尿素酶实验阴性，提示无 HP感染，其中6例胃体组织显示轻度慢性炎症（13．3％），39例无炎症（86．7％）；无肠化生及上皮内瘤变。qRT-PCR结果显示HP感染胃黏膜中Bax mRNA的表达明显高于 HP未感染胃黏膜患者（P＜0．01）且与胃炎程度呈明显正相关（P＜0．01），而Bak和Bcl-2的表达在两组间差异无统计学意义（ P＞0．05）。结论 H P感染的慢性胃炎程度与胃黏膜细胞凋亡呈正相关，提示H P感染可能导致胃上皮细胞中Bax基因的表达从而促进细胞凋亡。
목적：탐토유문라간균（H P ）감염상관위염정도여위점막세포조망기인표체적상관성。방법장2013년11～12월대평의원소화내경중심45례만성위염환자납입연구，쾌속뇨소매실험화13 C-호기실험검측H P감염정황，병리분석H P감염부위위염엄중정도，실시정량PCR （qRT-PCR）법검측HP감염부위위점막조직화무 HP감염적위점막조직중조망상관기인Bax、Bak、Bcl-2적표체，Person상관분석 HP감염적만성위염정도여조망기인표체적상관성。결과45례환자13 C-호기실험화위두점막쾌속뇨소매실험균양성，제시H P감염。병리결과현시45례（100％）환자균위만성위두위염，기중28례（62．2％）위경도，16례（35．6％）위중도，1례（2．0％）위중도；9례（20．0％）장화생，5례（11．1％）저급별상피내류변。45례환자위체점막뇨소매실험음성，제시무 HP감염，기중6례위체조직현시경도만성염증（13．3％），39례무염증（86．7％）；무장화생급상피내류변。qRT-PCR결과현시HP감염위점막중Bax mRNA적표체명현고우 HP미감염위점막환자（P＜0．01）차여위염정도정명현정상관（P＜0．01），이Bak화Bcl-2적표체재량조간차이무통계학의의（ P＞0．05）。결론 H P감염적만성위염정도여위점막세포조망정정상관，제시H P감염가능도치위상피세포중Bax기인적표체종이촉진세포조망。
Objective To investigate the correlation between Helicobacter pylori (HP) infection-associated gastritis and the ap-optotic genes in gastric mucosa .Methods Forty-five patients with chronic gastritis were registrated in our study from November 2013 to December 2014 .HP infection status in the patients was detected by using urease test and 13C-urea breath test .The degree of gastritis in the gastric mucosa with HP infection was confirmed via histopathology .qRT-PCR was used to measure the mRNA ex-pressions of Bax ,Bak and Bcl-2 in the gastric mucosa with HP infection and matched normal gastric mucosa .Person analysis was used to assess the correlation between the HP infection-associated gastritis and the mRNA expressions of Bax ,Bak and Bcl-2 in the gastric mucosa .Results Forty-five patients with HP infection in antrum and 45 patients (100% ) with chronic antrum gastritis were identified ,including 28 patients (62 .2% ) with light gastritis ,16 patients (35 .6% ) with moderate gastritis ,1 patient (2 .0% ) with severe gastritis .9 patients (20 .0% )with metaplasia ,5 patients(11 .1% ) with low grade intraepithelial neoplasms .The urease tests were negative in the gastric body of 45 patients ,6 patients (13 .3% )were mild chronic gastritis in the body ;Patient with meta-plasia and intrapithelial gastritis was not found .The Bax expression in the HP-infected gastric mucosa was markedly increased when compared with the normal gastric mucosa (P< 0 .01) ,and positively correlated with the degree of gastritis (P< 0 .01) , whereas the expressions of Bak and Bcl-2 have no significantly deferences bttween two groups(P>0 .05) .Conclusion HP infec-tion-associated gastritis positively correlated with the expressions of apoptotic genes in gastric mucosa ,suggesting that HP infection might result in increasing the Bax expression and further enhancing the cell apoptosis .