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目的 :探讨幽门螺杆菌 (Helicobacterpylori,HP)的特异蛋白 :空泡形成毒素A(VacuolatingcytotoxinA ,VacA)、细胞毒素相关蛋白A(CytotoxinassociatedproteinA ,CagA)、尿素酶A(UreaseA ,UreA) ,以及另外 3种蛋白 (分子量分别为 19.5kD ,2 6 .5kD ,35kD)的血清抗体滴度的变化在HP根除诊断中的意义 ,并分析HP阳性的消化性溃疡中影响溃疡复发的因素。方法 :采用山东胃癌高发区人群调查的样本 ,进行胃镜检查 ;以WesternBlot的方法检测病人血清中的抗体 ,并以德国LEICAQ 5 5 0IW软件系统对抗体的滴度进行测定。将HP阳性的溃疡病人随机分成两组 ,分别给予三联杀菌治疗或安慰剂 ,1年后进行复查对比。结果 :( 1)HP根治组的血清抗体滴度较治疗前下降 41.2 %～ 5 9.7% ,两年相比有明显差别 (P <0 .0 0 1) ;而安慰剂组两年相比 ,血清中抗体的滴度无明显变化 (P >0 .1)。 ( 2 )HP阳性的消化性溃疡病人中 ,接受HP根治者 ,1年后溃疡的复发率为 7.4% ;而接受安慰剂者 ,溃疡复发率为 5 5 .0 %。结论 :( 1)HP根除后1年 ,血清中HP特异蛋白的抗体滴度下降至治疗前的 41.2 %～ 5 9.7% ,此范围可作为HP根除的参考。 ( 2 )溃疡是否复发与患者的HP是否根除密切相关。
Objective: To investigate the specific proteins of Helicobacter pylori (HP): Vacuolatingcytotoxin A (VacA), Cytotoxus inociated protein A (CagA), Urease A (UreA) (Molecular weight 19.5kD, 26.5kD, 35kD respectively) in the diagnosis of HP eradication, and analyze the influencing factors of ulcer recurrence in HP-positive peptic ulcer. Methods: The gastroscopy was performed on a sample from a population surveyed in a high prevalence area of gastric cancer in Shandong Province. Antibodies in the serum of the patients were detected by WesternBlot and the titer of the antibody was determined by the LEICAQ550IW software system. HP-positive ulcer patients were randomly divided into two groups, respectively, triple therapy or placebo, compared to a review after 1 year. Results: (1) The titer of serum antibody in HP radical group decreased 41.2% ~ 57.9% compared with before treatment, there was a significant difference between two years (P <0.01); compared with two years in placebo group, Serum antibody titer no significant change (P> 0 .1). (2) Among patients with HP-positive peptic ulcer, the rate of ulcer recurrence was 7.4% in 1 h after HP radical treatment, while that in placebo was 55.0%. Conclusions: (1) After 1 year of HP eradication, the antibody titers of HP specific protein in serum decreased to 41.2% -5 9.7% before treatment, which could be used as a reference for HP eradication. (2) whether the ulcer recurrence is closely related to whether the patient’s HP is eradicated.