免疫印迹试验在诊断儿童幽门螺旋杆菌感染中应用评价.docVIP

免疫印迹试验在诊断儿童幽门螺旋杆菌感染中应用评价 　 作者：陈运生，周少明，刘彬，孙玲玲 【关键词】 免疫印迹试验 　　［摘 要］ 目的：评价免疫印迹试验(Western Blotting)在诊断不同年龄组及不同病理表现儿童幽门螺旋杆菌(Helicobacter pylori,HP)感染中的应用价值。方法：对450例有消化道症状的患儿，进行胃镜检查并取病变处胃黏膜组织行病理学检查，以及13C尿素呼气试验(13Curea breath test,13CUBT)、血清免疫印迹试验及胃液HPDNA PCR检查。结果：在4岁~6岁和6岁~12岁组患儿中，13CUBT HP检出率明显高于免疫印迹试验(P＜0.01)；在12岁~18岁组患儿中，13CUBT HP检出率与免疫印迹试验比较差异无显著性(P＞0.05)。细胞毒性基因相关蛋白(Cytotoxinassociated gene protein)阳性的HP感染在溃疡病组明显高于慢性胃炎组和正常组(P＜0.05)，慢性胃炎组CagA(Cytotoxinassociated gene protein，CagA) 阳性 HP显著高与正常组(P＜0.05)。结论：在12岁以上的少年患儿中，免疫印迹试验可作为快速诊断HP感染的可靠手段，并且能判断出是否为产毒菌株感染。在12岁以下的儿童中，免疫印迹试验最好与13CUBT联合使用。 　　［关键词］ 免疫印迹试验；13C尿素呼气试验；幽门螺旋杆菌；细胞毒性基因相关蛋白；儿童 　　The Evaluation of Western Blotting Method for the Diagnosis of Helicobacter Pylori Infection in Children 　　　Abstract：Objective To evaluate the accuracy of the Western Blotting test in the diagnosis of Helicobacter pylori(HP) in different age groups with various gastric illnesses in children.Methods 450 children with digestive tract symptoms were tested for HP using pathological histology,13CUBT,serum western blotting and HPDNAPCR.Results In the groups with ages from 4 to 6 and 6 to12 years the detection frequency using13CUBT were significantly higher than Western blotting (P＜0.01).In the group with ages from 12 to 18 years,there was no difference between13CUBT and Western Blotting in detection(P＞0.05).Positive rate of Cag A antibody in peptic ulcer group was significantly higher than that of chronic gastritis group (P＜0.05),Positive rate of Cag A antibody in chronic gastritis group was significantly higher than that of normal control group (P＜0.05).Conclusion It is rapid and dependable that the Western Blotting can be used to examine the HP antibodies in children with ages above twelve years and to determine the type of HP. 　　Key words：Western Blotting;13Curea breath test;Helicobacter pylori;Cytotoxinassociated gene protein;Children 幽门螺旋杆菌(Helicobacter pylori,HP)与胃肠疾病的发病关系目前正在被广泛研究。HP的致病因素包括CagA、VacA、菌毛、尿素酶、鞭毛等，其中以CagA、VacA最为重要，它们是HP毒力的标志