摘要
目的观察不同毒素分型的幽门螺杆菌(Helicobacter pylori,H.pylori)感染与慢性胃炎、萎缩、肠化生、早期胃癌的关系,探索与说明抗体分型检测的临床意义。方法收集2020年1月至2020年12月检查幽门螺杆菌抗体分型,并近期进行胃镜和活组织病理检查的568例患者。根据H.pylori是否感染、年龄、H.pylori抗体分型以及胃镜诊断和病理诊断分型分为3组,分别为慢性非萎缩性胃炎组(277例)、慢性萎缩性胃炎+肠化生组(260例)和早期胃癌组(31例)。分析不同毒素分型的H.pylori感染与患者年龄、不同胃镜诊断和病理诊断分型的关系。结果慢性萎缩性胃炎+肠化生组和早期胃癌组50岁及以上、男性及H.pylori阳性的比例,明显高于慢性非萎缩性胃炎组,组间差异有统计学意义(P<0.05)。慢性非萎缩性胃炎组中,<50岁患者H.pylori CagA和VacA抗体阳性率明显高于≥50岁患者,差异有统计学意义(P<0.05)。而慢性萎缩性胃炎+肠化生组不同年龄间H.pylori抗体分型差异无统计学意义(P>0.05)。3组胃黏膜病变患者H.pylori菌株感染情况比较,差异均有统计学意义(P<0.05),慢性萎缩性胃炎+肠化生组和早期胃癌组高毒力菌株感染比例及低毒力菌株感染比例均高于慢性非萎缩性胃炎组。结论慢性H.pylori感染与慢性萎缩性胃炎和肠化生、早期胃癌等胃黏膜病变的发生有相关性,H.pylori高毒力菌株感染与萎缩性胃炎+肠化生、早期胃癌发生有相关性。H.pylori低毒力菌株感染者中患慢性萎缩性胃炎和肠化生、早期胃癌等胃黏膜病变者占有一定比例,依据H.pylori毒力抗体分型来预测患者胃黏膜病变情况以及帮助决策是否根除H.pylori的可信度仍需探讨。
Objective To observe the relationship between Helicobacter pylori(H.pylori)infection with different toxin types and different gastric mucosa lesions,and to explain the clinical significance of antibody typing detection.Methods A total of 568 patients were enrolled who underwent antibody typing of H.pylori and gastroscopy and biopsy from January 2020 to December 2020,and they were grouped by H.pylori infection,age,H.pylori antibody typing,gastroscopic diagnosis and pathological diagnosis.The relationship between H.pylori infection with different toxin types and patients'age,gastroscopic diagnosis and pathological diagnosis was analyzed.Chi-square test was used for statistical analysis.Results The proportion of positive patients greater than or equal to 50 years old,male and H.pylori in chronic atrophic gastritis and intestinal metaplasia group and early gastric cancer group was significantly higher than that in the control group,with a statistical significance(P<0.05).In the chronic non-atrophic stomach group,the positive rates of H.pylori CagA and VacA antibodies in patients<50 years old were significantly higher than those in patients≥50 years old,with statistical significance(P<0.05).However,there was no significant difference in the typing of H.pylori antibody in the chronic atrophic gastritis and intestinal metaplasia group(P>0.05).There were statistically significant differences in H.pylori strain infection among patients with gastric mucosal lesions in the three groups(P<0.05).The infection proportions of high-virulence strain and low-virulence strain in chronic atrophic gastritis and intestinal metaplasia group and early gastric cancer group were higher than those in chronic non-atrophic gastritis group.Conclusion Chronic H.pylori infection is associated with chronic atrophic gastritis,intestinal metaplasia,early gastric cancer and other gastric mucosal lesions,while H.pylori high virulence strain infection is associated with atrophic gastritis,intestinal metaplasia,and early gastric cancer.Chronic atrophic gastritis,intestinal metaplasia,early gastric cancer and other gastric mucosal lesions in patients infected with H.pylori low virulence strain still account for a certain proportion.It remains to explore the reliability of the classification of H.pylori virulence antibody in predicting gastric mucosal lesions in patients and helping to make decisions on whether to eradicate H.pylori.
作者
苏珈仪
刘春涛
王铁山
李文坤
杨奕
武珊珊
李鹏
吴静
Su Jiayi;Liu Chuntao;Wang Tieshan;Li Wenkun;Yang Yi;Wu Shanshan;Li Peng;Wu Jing1(Department of Gastroenterology,Beijing Friendship Hospital,Capital Medical University,National Clinical Research Center for Digestive Diseases,Beijing Digestive Disease Center,Beijing Key Laboratory for Precancerous Lesion of Digestive Diseases,Beijing 100050,China;Department of Laboratory Medicine,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《首都医科大学学报》
CAS
北大核心
2022年第2期216-220,共5页
Journal of Capital Medical University
基金
西藏自治区自然科学基金组团式援藏医学项目[XZ2019ZR-ZY35(Z)]。
关键词
幽门螺杆菌抗体
胃炎
萎缩性
肠化生
早期胃癌
Helicobacter pylori antibody
gastritis
atrophic
intestinal metaplasia
early gastric cancer
