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[目的]建立幽门螺杆菌(Hp)免疫型分析方法,探讨不同人群Hp免疫性的临床意义。[方法]将健康体检者200例作为普通人群组,将有上消化道症状的门诊患者325例作为门诊患者组,进行病史调查并抽血作Hp-IgG免疫印迹法检测。比较两组之间Hp-IgG的检出率及Hp毒力相关特异印迹带的检出率及反应强度的差异。[结果]门诊患者组与普通人群组近3个月受检者上消化道症状的发生率分别为100%和33.5%,用药史为76.3%和26.5%。但两组Hp-IgG的阳性率分别为69.8%和65.0%,CagA、VacA、UreA以及低分子量蛋白的抗体检出率分别为58.5%、55.7%、49.2%、52.6%和52.0%、50.5%、48.0%、46.55%,两组间差异无统计学意义。而CagA、VacA、UreA以及低分子量蛋白的抗体滴度强弱及比例(免疫型)有明显的差异。[结论]研究结果表明,Hp感染并不是上消化道疾病出现症状的最主要原因,而与Hp感染的免疫型有明显的关系。Hp的致病作用与Hp长期感染及毒素的慢性作用有关。Hp感染的免疫型可作为评价Hp致病性及指导临床根除Hp的重要作用依据。
[Objective] To establish an immunological analysis method of Helicobacter pylori (Hp) to explore the clinical significance of Hp immunity in different populations. [Method] Two hundred and fifty healthy subjects were selected as the general population group, and 325 outpatients with upper gastrointestinal symptoms were selected as the outpatient group. Their medical history and blood samples were collected for Hp-IgG immunoblotting. The detection rate of Hp-IgG and the difference of the detection rate and reaction intensity of Hp virulence-related special blots were compared between the two groups. [Results] The prevalences of upper gastrointestinal symptoms in the outpatient group and the general population in the recent 3 months were 100% and 33.5%, respectively, and the medication history was 76.3% and 26.5% respectively. The positive rates of Hp-IgG in the two groups were 69.8% and 65.0%, respectively. The positive rates of CagA, VacA, UreA and low molecular weight proteins were 58.5%, 55.7%, 49.2%, 52.6% and 52.0%, 50.5% , 48.0% and 46.55% respectively. There was no significant difference between the two groups. The antibody titers of CagA, VacA, UreA, and low molecular weight proteins were significantly different from those of immunized ones. [Conclusion] The results show that Hp infection is not the most important cause of symptoms of upper gastrointestinal diseases, but has obvious relationship with the immunotype of Hp infection. The pathogenic role of Hp is associated with long-term Hp infection and the chronic effects of toxins. Hp infection of the immune type can be used as evaluation of Hp pathogenicity and guide the clinical eradication of Hp important role.