【摘要】 目的探讨胆囊幽门螺杆(Hp)菌感染与胆囊壁胆囊收缩素(CCK-A)受体mRNA表达的关系。方法采用对照研究方法对35例单纯胆囊结石患者(实验组)及25例单纯胆囊息肉样病变患者(对照组)的胆囊排空功能进行检测,用聚合酶链反应(PCR)方法检测两组患者的胆汁Hp细胞毒素相关基因抗原(cagA),用逆转录(RT)-PCR方法检测两组患者胆囊壁CCK-A受体mRNA的表达。结果实验组空腹胆囊体积、胆囊排空率均低于对照组,差异有统计学意义(t=3．694,t=3．484,P＜0．05)；实验组胆囊壁CCK-A受体mRNA的相对表达量(1．2±0．3)%低于对照组(13．6±5．7)%,差异有统计学意义(t=4．39,P＜0．05),并且,胆囊壁CCK-A受体mRNA表达的变化与胆囊排空率呈显著正相关(r=0．874,P＜0．05)；实验组胆汁标本中Hp cagA基因7例阳性(20．0%,7/35),对照组胆汁标本均阴性。两组胆汁Hp cagA检出率差异有统计学意义(x~2=3．886,P＜0．05),且胆汁Hp cagA基因检出与胆囊壁CCK-A受体mRNA的表达量相关,差异有统计学意义(X~2=3．886,P＜0．05)。结论胆囊结石患者中胆囊壁CCK-A受体基因表达下调,基因表达量的降低与胆囊排空功能障碍有关,胆囊Hp感染可能参与了这一病理生理过程。更多还原

【Abstract】 Objective To investigate the relationship between Helicobacter pylori and the chole- cystokinin (CCK-A) receptor mRNA expression in gallbladder wall of the patients with cholelithiasis. Methods By controlled trial method,the emptying function of gallbladder was tested in 35 patients with simple cholelithiasis (study group) and 25 patients with simple cholecyst polyposis (control group).The CCK-A receptor mRNA in gallbladder wall of two groups were amplified by RT-PCR,and the Helicobac- ter pylori cytotoxin associated gene antigen (cag-A) was amplified by PCR in bile and gallstone groups. Results The gallbladder emptying rate in study group was lower than in control group (t=3.484,P＜0.05).The CCK-A receptor mRNA expression in study group was lower than in control group [(1.2±0.3)% vs (13.6±5.7)%,t’=4.39,P＜0.05].And the change of CCK-A receptor mRNA expression was significantly correlated with gallbladder emptying (r=0.874,P＜0.05).There was difference be- tween two groups in the infection rate of Helicobacter pylori.Seven of 35 bile specimens (20.0%) in study group were positive for Hp cag-A gene and none of 25 bile specimens were positive in control group (X~2= 3.886,P＜0.05) by PCR.There was a relationship between CCK-A receptor mRNA expression and Hp cag-A gene (X~2=3.886,P＜0.05).Conclusion The expression of CCK-A receptor mRNA was reduced in gallbladder of the patients with cholelithiasis,which led to the impairment of the gallblad- der emptying function of cholelithiasis patients.It was suggested that Helicobacter pylori might take part in this pathophysiological process.更多还原