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目的 通过比较消化性溃疡和慢性胃炎病人血清中CagA抗体阳性的流行情况 ,探讨消化性溃疡和血清幽门螺杆菌CagA蛋白抗体滴度之间的关系。方法 采用病例对照研究设计方案。研究对象来源于中山医院门诊因中上腹痛或腹胀进行胃镜检查的人群。自 1998年 10月 -1998年 12月共收集胃溃疡病例 2 6例 ,十二指肠球部溃疡 2 7例 ,对照组为同期胃镜和病理证实慢性浅表性胃炎的病例 6 5例。Hp感染的判断采用快速尿素酶和病理Giemsa相结合的方法 ,二者均阳性定为阳性。采用ELISA方法检测HpCagA抗体。结果 总的HpCagA抗体的阳性率为 6 2 5 % ,在胃溃疡组为 76 9% ( 2 0 / 2 6 ) ,在十二指肠球部溃疡组为 88 9% ( 2 4/ 2 7) ,在慢性胃炎组为 49 3 % ( 3 2 / 6 5 ) ,胃溃疡组和十二指肠球部溃疡组均明显高于慢性胃炎组 ,差异有显著性。结论 本研究提示CagA蛋白阳性的幽门螺杆菌菌株在消化性溃疡的发病中起一定作用。
Objective To compare the prevalence of CagA antibody in sera of patients with peptic ulcer and chronic gastritis to explore the relationship between peptic ulcer and antibody titer of Helicobacter pylori CagA protein. Methods Case-control study design. The subjects were from Zhongshan Hospital outpatients with gastroscopy because of upper abdominal pain or abdominal distension. Twenty-six cases of gastric ulcer and 27 cases of duodenal ulcer were collected from October 1998 to December 1998. The control group included 65 cases of chronic superficial gastritis confirmed by gastroscopy and pathology in the same period. Hp infection was judged by a combination of rapid urease and pathological Giemsa, both positive as positive. HpCagA antibody was detected by ELISA. Results The positive rate of total HpCagA antibody was 62.5%, 76.9% (20/26) in gastric ulcer group, 88.9% (24/27) in duodenal ulcer group, , 49.3% (32/65) in chronic gastritis group, ulcer group in gastric ulcer group and duodenal ulcer group were significantly higher than those in chronic gastritis group, the difference was significant. Conclusions This study suggests that CagA protein-positive Helicobacter pylori strains play a role in the pathogenesis of peptic ulcer.