江汉大学学报(自然科学版) ›› 2023, Vol. 51 ›› Issue (4): 73-78.doi: 10.16389/j.cnki.cn42-1737/n.2023.04.009

• 医学 • 上一篇    

幽门螺旋杆菌抗体分型与胃部疾病的关系

彭梦巧1 ,金 雷*2   

  1. 1. 江汉大学 医学部,湖北 武汉 430056;2. 湖北省第三人民医院 消化内科,湖北 武汉 430033
  • 发布日期:2023-08-19
  • 通讯作者: 金 雷
  • 作者简介:彭梦巧(1994— ),女,硕士生,研究方向:消化内科学。

A Case of Central Pontine Myelinolysis Secondary to Perioperative Triphasic Diabetes Insipidus in Children with Craniopharyngioma and Literature Review

PENG Mengqiao1 ,JIN Lei*2   

  1. 1. School of Medicine,Jianghan University,Wuhan 430056,Hubei,China;2. Department of Gastroenterology, The Third People's Hospital of Hubei Province,Wuhan 430033,Hubei,China
  • Published:2023-08-19
  • Contact: JIN Lei

摘要: 目 的 统计分析不同抗体类型幽门螺旋杆菌(Helicobacter pylori,Hp)感染在胃黏膜各 阶段病变状态(非萎缩性胃炎、萎缩性胃炎、胃溃疡、上皮内瘤变、胃癌)的分布关系及其临床意 义。方 法 纳入 2019-2021 年在江汉大学附属湖北省第三人民医院就诊 2 081 例住院患者,行 C13呼气试验、血清学抗体检查、胃镜及病理学检查,根据胃镜及病理学检查结果将其分为非萎缩 性胃炎(917 例)、萎缩性胃炎(636 例)、胃溃疡(406 例)、上皮内瘤变(89 例)、胃癌(33 例)五组,统 计分析不同毒素分型的 Hp 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 各 组 Hp 感染率从高到低依次为胃癌组、上皮内瘤变组、萎缩性胃炎组、胃溃疡组、非萎缩性胃炎组, 各组 Hp 感染率比较差异有统计学意义(P < 0. 05);2 081 例患者中共检出Ⅰ型 Hp 653 例,Ⅱ型 Hp 324 例,各组 HpⅠ型阳性率高于Ⅱ型阳性率比较差异有统计学意义(P < 0. 05);各组 HpⅠ型 阳性率、Ⅱ型阳性率比较差异有统计学意义(P < 0. 05);各组细胞毒素相关蛋白 A(CagA)、细胞 空泡毒素(VacA)、尿素酶(Ure)比较差异有统计学意义(P < 0. 05),并且随着年龄增长( ≥ 50 岁),Ure 抗体呈明显上升趋势;Ⅰ型 Hp 阳性 653 例患者中,以 CagA + VacA 抗体(60. 0%)为主, 高于 CagA 抗体(36. 2%)及 VacA 抗体(3. 6%),差异有统计学意义(P < 0. 05);Ⅱ型 Hp 阳性 324 例 患者中,各组 UreB 抗体阳性率(64. 8%)高于本组 UreA + UreB 抗体阳性率(30. 5%)以及 UreA 抗体阳性率(4. 6%),差异有统计学意义(P < 0. 05)。结 论 胃部疾病与 Hp 感染密切相关,尤 其是Ⅰ型 Hp 高毒力菌株为胃部疾病的主要致病菌株,但Ⅱ型 Hp 菌株感染不可忽视。

关键词: 幽门螺旋杆菌, 幽门螺旋杆菌抗体, 胃部疾病

Abstract: Objective To statistically analyze the distribution and clinical significance of different antibody types of Helicobacter pylori(Hp) infection in various stages of gastric mucosa lesions (non-atrophic gastritis, atrophic gastritis, gastric ulcer, intraepithelial neoplasia,and gastric cancer). Methods 2 081 inpatients admitted to the Third People's Hospital of Hubei Province Affiliated to Jianghan University from 2019 to 2021 were enrolled. The C13 breath test, serological antibody test, gastroscopy, and pathological examination were performed simultaneously. According to the results of gastroscopy and pathological examination,the patients were divided into five groups:non-atrophic gastritis (917 cases),atrophic gastritis (636 cases),gastric ulcer (406 cases),intraepithelial neoplasia(89 cases),and gastric cancer(33 cases). The relationship between Hp infection with different toxin types and patients' age,gastroscopy,and pathological diagnosis was statistically analyzed. ResultsThe infection rate of Hp in each group from high to low was gastric cancer group,intraepithelial neoplasia group,atrophic gastritis group,gastric ulcer group,and non-atrophic gastritis group,and the difference was statistically significant (P < 0. 05). A total of 653 cases of type I Hp and 324 cases of type II Hp were detected in 2 081 patients. The positive rate of type I Hp was higher than that of type II Hp in each group,and the difference was statistically significant(P < 0. 05). There were significant differences in the positive rate of type I Hp and type II Hp among all groups(P < 0. 05). There were significant differences in cytotoxin-associated protein A(CagA),vacuolar toxin (VacA),and urease(Ure)among all groups(P < 0. 05),and Ure antibody increased with age(≥ 50). Among 653 patients with type I Hp positive,the CagA + VacA antibody (60. 0%) was the main antibody,which was higher than CagA antibody (36. 2%) and VacA antibody (3. 6%),and the differences were statistically significant (P < 0. 05). Among 324 patients with type II Hp positive,the positive rate of UreB antibody(64. 8%) in each group was higher than that of UreA + UreB antibody(30. 5%)and UreA antibody (4. 6%),and the difference was statistically significant (P < 0. 05). Conclusion Hp infection is closely related to gastric mucosal lesions. Type I Hp strain is the main pathogenic strain of gastric diseases,but type II Hp strain infection should not be ignored.

Key words: Helicobacter pylori, antibodies to Helicobacter pylori, disease of the stomach

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