幽门螺杆菌相关性胃疾病患者末梢血中Hp

张玲霞　张沥　刘永国　张宁霞

【摘要】目的 了解细胞毒素相关蛋白A在Hp相关性胃疾病中的检出情况,并对所采用的方法进行评价。方法 采用斑点金免疫渗滤试验(DIGFA),对168例胃粘膜活检组织快速尿素酶试验、PCR检测及Warthin-Starry染色任二项Hp阳性者的末梢血进行Hp-CagAIgG检测。结果 168例Hp阳性者中,142例Hp-CagAIgG阳性(84.52%),其中慢性浅表性胃炎65.63%(21/32),慢性萎缩性胃炎78.57%(33/42),十二指肠球部溃疡94.74%(36/38),胃溃疡91.67%(33/36),胃癌95%(19/20)。结论 DIGFA能够快速诊断CagA阳性Hp感染,与ELISA法相比除具有较高的特异性及敏感性外,还具有简便、快速、准确等特点。
【关键词】幽门螺杆菌　细胞毒素相关蛋白A　斑点金免疫渗滤试验　胃疾病

Detection of Hp-CagA IgG in blood ending in Hp-infected gastroduodenal diseases.

Zhang Lingxia,Zhang Li,Liu Yongguo,et al.
Department of Gastroenterology,Xian Central Hospital,Xian 710003.

【Abstract】Objective To investigate the prevalence of cytotoxin associated gene A(CagA)in Hp-infected gastroduodenal diseases and to evaluate the methods used.Methods 168 Hp-infected patients were examined to see if they have Hp-CagA IgG in their peripherat blood by dot immunogold filtration assay(DIGFA)who were examed by rapid urase,PCR and Warthin-Starry stain and two of these three examinations were positive.Results 142 in 168 patients were detected to have Hp-CagA IgG in their peripheral blood(85.52%),including chronic superficial gastritis 65.63%(21/32),chronic atrophic gastritis78.57%(33/42),duodenal ulcer94.74%(36/38),gastric ulcer 91.67%(33/36)and gastric cancer95.00%(19/20).Conclusion DIGFA may be used to detect CagA-Hp infection,not only shows better sensitivity and specificity,but also shows convenient,rapid and reliable features compared with ELISA.
【Key words】　Helicobacter pylori　Cytotoxin associated gene A　Dot immunogold filtration assay　Stomach disease

　　现已确认,幽门螺杆菌(Hp)是慢性萎缩性胃炎及消化性溃疡的主要致病因素之一,与胃癌的发生也有密切关系,人群中Hp感染率在50%以上,其中60%～80%的Hp含有细胞毒素相关蛋白A(CagA),产生cagA基因,与消化系统疾病的关系十分密切［1-3］。斑点金免疫渗滤试验(DIGFA)具有简便、快速、敏感、特异检测CagA等。本研究采用该方法对168例胃粘膜活检组织行快速尿素酶试验、PCR检测以及Warthin-Starry染色检测Hp任二项阳性者的末梢血进行Hp-CagA-IgG检测,以期达到快速诊断CagA阳性Hp感染的目的,并了解各种胃病与Hp-CagA感染的相互关系,指导Hp相关性胃疾病的防治。

材料与方法
　　一、材料:胃粘膜组织标本全部来自西安市中心医院消化科门诊及住院患者,经胃镜检查

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