【摘要】 目的研究淮南地区幽门螺杆菌(Helicobacter pylori,H.pylori,Hp)iceA1、babA2基因分布特征及其细胞免疫功能。方法对244例有消化道症状者行胃镜检查,并在胃窦部取活检粘膜作Hp的分离培养,利用聚合酶链反应技术(PCR)测定分离培养出的Hp菌株的iceA1、babA2基因,并采用生物素-链霉亲和素(biotin-sreptavidin,BSA)系统检测患者外周血T细胞亚型,ELISA法检测其细胞因子。结果244例中,检出Hp菌株185例,其中慢性胃炎、萎缩性胃炎、胃溃疡及十二指肠球部溃疡阳性率分别为70.65%(65/92)、74.14%(43/58)、85.25%(52/61)及75.76%(25/33);基因测定结果显示,185株分离株中,79.46%(147/185)含iceA1基因,75.14%(139/185)含babA2基因;其中慢性胃炎、萎缩性胃炎、胃溃疡及十二指肠球部溃疡iceA1、babA2基因检出率分别为66.15%(43/65)、56.92%(37/65);79.07%(34/43)、74.42%(32/43);90.38%(47/52)、88.46%(46/52);92.00%(23/25)、96.00%(24/25);差异均具显著性(P<0.01)。细胞免疫功能检测,iceA1+、babA2+患者的CD+3、CD+4、CD+4/CD+8、IL-2下降,IL-6、IL-8水平升高,差异有显著性(P<0.001)。结论淮南地区Hp感染多为iceA1+、babA2+菌株,iceA1+、babA2+Hp菌株为高毒力菌株,是致消化性溃疡的重要因素;iceA1+、BabA2+菌株可使患者细胞免疫功能下降,引起患者以Th1为主的浸润反应。更多还原

【Abstract】 To investigate the distribution of iceA1 and babA2 genesand its cell immunity function from Helicobacter pylori in Huainan area of Anhui province.Gastroscopy was performed in 244 patients with gastrointestinal symptoms,meanwhile the gastric biopsy specimens were obtained from antrum and used for isolation of Hp.The types of iceA1 and babA2 from Hp were determined by using polymerase chain reaction（PCR）.The T cell subtype of patients was detected by biotin-streptavidin（BSA） system,and the presence of cytokines was assayed with ELISA.The results showed that a total of 185 Hp isolates were obtained from 244 patients,and the detection rates of in chronic gastritis cases,atrophic gastritis,gastric and dunodenal ulcer cases were 70.65%（65/92）,74.14%（43/58）,85.25%（52/61） and 75.76%（25/33）,respectively.Of the 185 Hp strains,79.46%（147/185）had iceA1 gene and 75.14%（139/185）had babA2 gene.The detection rates of iceA1 and babA2 gene in chronic gastritis,atrophic gastritis,gastric and dunodenal ulcer cases were 66.15%（43/65） and 56.92%（37/65）,（79.07%）（34/43） and 74.42%（32/43）,90.38%（47/52） and 88.46%（46/52）,92.00%（23/25） and 96.00%（24/25）,respectively.Both of the statistics were all significant differences（P<0.01）.Furthermore,The percentage of CD⁺₃,CD⁺₄,CD⁺₈,the ratio of CD4 / CD8,and the level of IL-2,IL-6,IL-8 in Hp-iceA1+ and babA2+ patients were（45.67±（5.89））%,（（24.26）±4.74）%,（22.15±6.45）%,（1.13±0.44）%,（（1.16）±0.38） mg/L,（116.45±5.44） ng/L,（118.64±6.24） ng/L,respectively,compared with those in Hp-iceA1-and babA2-patients,the percentage of CD⁺₃,CD⁺₄ and the ratio of CD4 / CD8 and IL-2 decreased,but the level of IL-6,IL-8 increased,and the difference was significant（P<（0.001））.It is concluded that the Hp infection in Huainan area is most likely due to the iceA1+,babA2+ strains,and the Hp strains with iceA1+ and babA2+ are highly virulent.Suggesting that they may play a important role in the development of peptic ulcer in patients.As to the Hp with iceA1+,babA2+ strains,the devrease of cellmediated immunity.thus facilitating the development of the Th1 type infiltration response may induce.更多还原