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目的探讨胆囊幽门螺杆(Hp)菌感染与胆囊壁胆囊收缩素(CCK-A)受体mRNA表达的关系。方法采用对照研究方法对35例单纯胆囊结石患者(实验组)及25例单纯胆囊息肉样病变患者(对照组)的胆囊排空功能进行检测,用聚合酶链反应(PCR)方法检测两组患者的胆汁Hp细胞毒素相关基因抗原(cagA),用逆转录(RT)-PCR方法检测两组患者胆囊壁CCK-A受体mRNA的表达。结果实验组空腹胆囊体积、胆囊排空率均低于对照组,差异有统计学意义(t=3．694,t=3．484,P＜0．05)；实验组胆囊壁CCK-A受体mRNA的相对表达量(1．2±0．3)%低于对照组(13．6±5．7)%,差异有统计学意义(t=4．39,P＜0．05),并且,胆囊壁CCK-A受体mRNA表达的变化与胆囊排空率呈显著正相关(r=0．874,P＜0．05)；实验组胆汁标本中Hp cagA基因7例阳性(20．0%,7/35),对照组胆汁标本均阴性。两组胆汁Hp cagA检出率差异有统计学意义(x~2=3．886,P＜0．05),且胆汁Hp cagA基因检出与胆囊壁CCK-A受体mRNA的表达量相关,差异有统计学意义(X~2=3．886,P＜0．05)。结论胆囊结石患者中胆囊壁CCK-A受体基因表达下调,基因表达量的降低与胆囊排空功能障碍有关,胆囊Hp感染可能参与了这一病理生理过程。
Objective To investigate the relationship between the infection of gallbladder pyloric screw (Hp) and the expression of cholecystokinin (CCK-A) receptor in gallbladder wall. Methods Gallbladder emptying function in 35 patients with simple gallstones (experimental group) and 25 patients with simple gallbladder polypoid lesions (control group) was detected by the comparative method. The two groups of patients were detected by polymerase chain reaction (PCR) Of bile Hp cytotoxin-related antigen (cagA), reverse transcription (RT) -PCR method was used to detect the gallbladder wall CCK-A receptor mRNA expression in both groups. Results The fasting gallbladder volume and gallbladder emptying rate in the experimental group were significantly lower than those in the control group (t = 3.694, t = 3.484, P <0.05). The CCK-A The relative expression level of mRNA (1.2 ± 0.3)% was lower than that of the control group (13.6 ± 5.7)%, the difference was statistically significant (t = 4.39, P <0.05) The expression of CCK-A receptor on the gallbladder wall was positively correlated with the rate of gallbladder emptying (r = 0.874, P <0.05). In the experimental group, 7 cases of Hp cagA gene were positive in bile samples (20. 0%, 7/35), the control group bile specimens were negative. The detection rate of Hp cagA between the two groups was significantly different (x ~ 2 = 3.886, P <0.05). The detection of Hp cagA gene in gallbladder was correlated with the expression of CCK-A receptor in gallbladder wall, The difference was statistically significant (X ~ 2 = 3.886, P <0.05). Conclusion The expression of CCK-A receptor in gallbladder wall is down-regulated in patients with gallstone. The decrease of gene expression is associated with dysfunction of gallbladder emptying. Hp infection of gallbladder may be involved in this pathophysiological process.