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目的探讨基因芯片检测幽门螺杆菌(Hp)感染患儿血细胞毒素相关基因A(CagA)、空泡毒素蛋白(VacA)、尿毒酶(Ure)、热休克蛋白60(Hsp60)和硝基还原酶(RdxA)等毒力因子分布情况及胃镜下组织学表现。方法选取2007年10月-2008年5月在本院住院,具有腹痛、呕吐、呕血、黑便等消化系统症状,经2种及2种以上方法确诊为Hp感染的患儿30例。经胃镜诊断分为胃炎组(n=23)和消化性溃疡组(n=7),观察相应的CagA、VacA、Ure、Hsp60和RdxA等毒力因子抗体在不同疾病的分布情况;同时观察其胃镜下胃组织学表现,评估Hp毒力因子抗体与胃镜下表现及相关疾病的关系。比较CagA在胃炎组和消化性溃疡组的分布情况,应用SPSS 17.0软件进行统计学处理。结果 30例Hp感染患儿的致病毒力因子分布情况:CagA阳性29例(占96.7%)、Ure阳性14例(占46.7%)、RdxA阳性7例(占23.3%)、Hsp60 3例(占10.0%)和VacA阳性1例(占3.3%)。消化性溃疡组CagA阳性率(100%)高于胃炎组CagA阳性率(95.7%),但差异无统计学意义(χ2=1.000,P>0.05)。胃镜下胃炎组表现为黏膜充血、水肿、点片状出血斑、颗粒样变性、花斑样变性,消化性溃疡组表现为溃疡、黏膜充血水肿、出血样变,有时伴有食管胃底静脉曲张。抗CagA阳性患儿对应黏膜改变最为广泛。结论 Hp感染与CagA、VacA、Ure、Hsp60和RdxA等毒力因子相关,与CagA关系最为密切,VacA与疾病的严重程度相关。CagA阳性能够增加细胞毒素的活性,但其结果并不能预示疾病发展为胃炎或者消化性溃疡。
Objective To investigate the expression of CagA, VacA, Ure, Hsp60, and nitroreductase (Hsp60) in children with Helicobacter pylori infection by gene chip. RdxA) and other virulence factors and histological findings under endoscopy. Methods Thirty patients with Hp infection who were diagnosed as having digestive system symptoms such as abdominal pain, vomiting, hematemesis, melena, etc. were admitted to our hospital from October 2007 to May 2008. Gastritis was divided into gastritis group (n = 23) and peptic ulcer group (n = 7) by gastroscopy. The distribution of antibodies against CagA, VacA, Ure, Hsp60 and RdxA were observed in different diseases. Gastroscopy under the stomach histological performance, evaluation of antibody to Hp virulence and endoscopic performance and related diseases. The distribution of CagA in gastritis and peptic ulcer groups was compared and analyzed by SPSS 17.0 software. Results The distribution of virulence factors in 30 children with Hp infection: 29 cases (96.7%) were positive for CagA, 14 cases (46.7%) were positive for Ure, 7 cases (23.3%) were positive for RdxA and 3 cases were Hsp60 Accounting for 10.0%) and VacA-positive in 1 (3.3%). The positive rate of CagA in peptic ulcer group (100%) was higher than that in gastritis group (95.7%), but the difference was not statistically significant (χ2 = 1.000, P> 0.05). Gastroscopy gastritis group showed mucosal congestion, edema, patchy hemorrhagic spot, granular degeneration, speckle degeneration, peptic ulcer group showed ulceration, mucosal congestion and edema, hemorrhage-like changes, sometimes accompanied by esophageal varices . CagA-positive children corresponding to the most widely changed mucosal. Conclusions Hp infection is associated with virulence factors such as CagA, VacA, Ure, Hsp60 and RdxA, and has the closest relationship with CagA. VacA is related to the severity of the disease. CagA positive can increase the cytotoxic activity, but the result does not predict the development of the disease as gastritis or peptic ulcer.