东亚型CagA+幽门螺杆菌感染与慢性胃炎患者病理表现及炎症活动的相关性

摘要

Objective To investigate the relationship between Helicobacter pylori (H.pylori) infection in East Asian type CagA+ and pathological manifestations and inflammatory activities in patients with chronic gastritis. Method 156 patients with chronic gastritis in the First Affiliated Hospital of Qiqihar Medical University from December 2010 to December 2015 were selected as objects of study. H.pylori and CagA+H.pylori in patients with chronic gastritis were examined, and the relationship between CagA+and different gastritis was analyzed. Result ①Among 156 patients with chronic gastritis, 64 cases were chronic superficial gastritis (CSG), 57 cases were chronic atrophic gastritis (CAG), and 35 cases were CAG with atypical hyperplasia (Dys), and the H.pylori infection rate was 68.59%;②H.pylori infection rate:CAG with Dys>CAG>CSG (P<0.05). East Asian CagA+H.pylori infection rate:CAG with Dys>CAG>CSG (P<0.05);③the East Asian CagA+H.pylori infection rate in patients with moderate or severe inflammatory reactions was higher than that in patients with mild inflammatory reaction (P<0.05);the East Asian CagA+H.pylori infection rate in patients with active inflammatory response was higher than that in patients without active inflammatory reaction (P<0.05). Conclusion East Asian CagA+H.pylori infection could aggravate the inflammatory reaction of patients with chronic gastritis, and promote the development of chronic gastritis to CAG and Dys.%目的：探讨东亚型CagA+幽门螺杆菌（H.pylori）感染与慢性胃炎患者病理表现及炎症活动的相关性。方法选取齐齐哈尔医学院附属第一医院2010年12月至2015年12月收治的156例慢性胃炎患者为研究对象，均行胃镜病理检查、H.pylori及CagA+H.pylori抗体检测，分析东亚型CagA+菌株与不同胃炎之间的关系。结果①156例慢性胃炎患者中，慢性浅表性胃炎64例，慢性萎缩性胃炎57例，慢性萎缩性胃炎伴不典型增生35例；156例患者中感染H.pylori 107例，感染率为68.59%；②H.pylori感染率：慢性萎缩性胃炎伴不典型增生＞慢性萎缩性胃炎＞慢性浅表性胃炎（P＜0.05）；东亚型CagA+H.pylori感染率：慢性萎缩性胃炎伴不典型增生＞慢性萎缩性胃炎＞慢性浅表性胃炎（P＜0.05）。③出现中、重度炎性反应的患者东亚型CagA+H.pylori感染率高于轻度炎性反应患者（P＜0.05）；有活动性炎性反应的患者东亚型CagA+H.pylori感染率高于无活动性炎性反应患者（P＜0.05）。结论东亚型CagA+H.pylori感染加重慢性胃炎患者胃黏膜的炎性反应，同时促进慢性胃炎向慢性萎缩性胃炎及不典型增生发展。