摘要目的 通过对胃十二指肠疾病患者幽门螺杆菌(H.pylori)多种抗体的蛋白芯片检测,评价H.pylori的尿素酶(Ure)、细胞毒素相关蛋白(CagA)、空泡毒素(VacA)、热休克蛋白60(Hsp60)与慢性胃炎、消化性溃疡、胃癌的相关性,并了解H.pylori的硝基还原酶(RdxA)表达与甲硝唑耐药的相关性.方法 经胃镜检查确诊的300例慢性胃十二指肠疾病患者,抽静脉血3ml离心取血清,用蛋白芯片技术检测H.pylori的Ure、CagA、VacA、Hsp60、RdxA五种抗体.结果 慢性胃炎、消化性溃疡、胃癌中H.pylori感染率为34.0％、58.0％、34.0％(P＜0.01)；在H.pylori感染的慢性胃炎、消化性溃疡、胃癌中CagA抗体阳性率分别为54.9％、75.9％、64.7％(P=0.070)；VacA抗体在三种疾病中阳性率分别为31.4％、22.4％、17.6％(P=0.412)；Hsp60抗体阳性率分别为56.9％、48.3％、41.2％(P=0.466)；RdxA抗体总阳性率为4.0％(5/126).结论 消化性溃疡与H.pylori感染及毒力因子CagA的作用密切相关(r=0.221,P=0.021)；而VacA、Hsp60与三种胃十二指肠疾病间未显示明确相关性(r =0.118、-0.110,P=0.187、0.220)；RdxA抗体水平不能完全代表甲硝唑耐药水平.

abstractsObjective To detect Helicobacter pylori (H.pylori) multiple antibodies of urease (Ure),cytotoxin associated gene A protein (CagA),vacuolating toxin A (VacA),heat shock protein 60 (Hap60) and nitroreductase ( RdxA),and disclose their relations with chronic gastritis,peptic ulcer and gastric cancer.Methods A volume (3 ml) of venous blood was taken from 300 patients of gastroduodenal disease diagnosed by endoscopy,to centrifuge and detect antibodies of Ure,CagA,VacA,Hsp60,RdxA by protein chip technique.Results The infective rates of H.pylori in chronic gastritis,peptic ulcer,and gastric cancer were 34.0％,58.0％,34.0％ ( P ＜ 0.01 ),respectively.In the H.pylori positive chronic gastritis,peptic ulcer and gastric cancer,the positive rates of CagA antibody were 54.9％,75.9％,64.7％ ( P =0.070) ; the positive rates of VacA antibody were 31.4％,22.4％,17.6％ ( P =0.412) ;and the positive rates of Hap60 antibody were 56.9％,48.3％,41.2％ ( P =0.466),respectively.The total positive rate of RdxA antibody was 4.0％ (5/126).Conclusions H.pylori infection and virulence factor CagA are closely related to peptic ulcer,while it did not show the exact correlation between VacA,Hsp60 and gastroduodenal disease.The level of RdxA antibody can not represent the level of H.pylori resistance to metronidazole.