【摘要】 目的探讨幽门螺杆菌(Hp)感染与胆色素结石形成的关系。方法取35例胆色素性结石患者(实验组)及10例对照组患者胆汁进行需氧菌、厌氧菌及Hp培养,采用PCR方法检测胆囊管黏膜、胆管黏膜、胆汁和胆石核心中的Hp-DNA;所有黏膜用Warthin-Starry银染色法染色,Western印迹法检测胆汁中Hp感染相关蛋白。结果所有胆汁培养均未发现Hp生长。实验组胆石核心、胆汁和黏膜的Hp-DNA扩增阳性率分别为14.29%、31.43%和56.67%。Hp-DNA阳性胆汁中,检出细胞毒素相关抗原(Cag A)7例,细胞空泡毒紊(Vae A)6例,同时检出Hp Vac A相关亚单位(相对分子质量37000)、糖蛋白(相对分子质量35000)、尿素酶B和尿素酶A。实验组30例胆管黏膜经Warthin- Starry染色后有7例(23.33%)镜下观察到类似Hp的菌体。对照组胆汁和黏膜Hp-DNA阴性,胆汁中未检出Hp感染相关蛋白.黏膜Warthin-Starry染色后,镜下未观察到类似Hp的菌体。结论胆色素结石患者胆道系统中存在Hp感染依据.并存在多种Hp感染相关蛋白,Hp感染可能参与胆色素性结石的形成。更多还原

【Abstract】 Objective To investigate the correlation between the formation of pigmented biliary calculus and biliary H.pylori infection.Methods Bile from 35 patients with pigmented biliary calculus and 10 healthy controls was cultured for aerobic,anaerobic and H.pylori.The expression of H.pylori- DNA in bile,bile duct mucosa and pigmented calculus were determined by PCR.The expression of H. pylori associated protein in bile duct mucosa was determined by Western-blot and Warthin-Starry staining.Results H.pylori culture was negative in all bile samples.In 35 patients with biliary pigmen- ted calculus,H.pylori was detected by PCR in the center of calculus,bile and bile duct mucosa of 14.29%,31.43% and 56.67% patients,respectively.Among H.pylori-DNA positive bile samples,7 contained anti-CagA antibodies,and 6 contained Vac A.in addition to Vacuolating cytotoxin(35000), glycoprotein(30000),Urase Band Urase A.Bacteria resembling H.pylori by Warthin-Starry stainning were found in 7 of 30(23.33%)bile duct mueosal samples from patients with biliary pigmented calculus. H.pylori-DNA and its associated protein were not detected in all bile and bile duct mucosae samples from the healthy controls.Conclusions The evidence of H.pylori-DNA and its associated protein in biliary system might indicate the role of H.pylori in the formation of biliary pigmented calculus.更多还原