Ⅰ型和Ⅱ型幽门螺杆菌感染对慢性胃炎的影响

doi:10.3969/j.issn.1673-8640.2025.08.013

摘要/Abstract

摘要：

目的分析不同抗体分型幽门螺杆菌（Hp）感染与胃部病理特征的关系，以及慢性胃炎患者血清胃功能指标[胃蛋白酶原（PG）Ⅰ、PGⅡ、胃蛋白酶原Ⅰ/胃蛋白酶原Ⅱ比值（PGR）、胃泌素17（G-17）]与Ⅰ型Hp感染、炎症活动性、萎缩程度、肠化生程度的相关性。方法选取2022年7月—2024年2月南方医科大学南方医院增城院区消化内科236例胃部良性疾病患者，其中Ⅰ型Hp抗体阳性78例（Ⅰ型Hp感染组）、Ⅱ型Hp抗体阳性47例（Ⅱ型Hp感染组）、Hp抗体阴性111例（对照组）。比较各组临床资料和相关实验室检测结果的差异。采用Spearman相关分析评价PGⅡ、PGR、G-17与胃部炎症活动性、萎缩程度（OLGA分期）、肠化生程度（OLGIM分期）、Ⅰ型Hp感染的相关性。结果 Ⅰ型Hp感染与胃部炎症活动性、OLGA分期、OLGIM分期呈正相关（P<0.05）。胃部炎症活动性为3级（+++）时，Ⅰ型Hp感染组感染率是Ⅱ型Hp感染组的4.9倍（P<0.05）。OLGA分期为Ⅲ期时，Ⅰ型Hp感染组感染率是Ⅱ型Hp感染组的2.1倍（P<0.05）；OLGIM分期为Ⅲ期时，Ⅰ型Hp感染组感染率是Ⅱ型Hp感染组的2.6倍（P<0.05）。对照组、Ⅰ型Hp感染组、Ⅱ型Hp感染组血清PGⅡ、PGR、G-17水平差异有统计学意义（P<0.05）。慢性胃炎患者血清PGⅡ与Ⅰ型HP感染、胃部炎症活动性、萎缩程度、肠化生程度呈正相关（P<0.05）；血清PGR与Ⅰ型Hp感染、炎症活动性、OLGA分期、OLGIM分期呈负相关（P<0.05）；血清G-17水平与Ⅰ型Hp感染和胃部炎症活动性、OLGIM分期呈正相关（P<0.05）。结论 Ⅰ型Hp感染对胃部良性疾病发展进程影响较大，慢性胃炎患者PGⅡ、PGR、G-17与Ⅰ型Hp感染和胃部炎症活动性、萎缩程度、肠化生程度有关。

关键词: 幽门螺杆菌, 抗体分型, 慢性胃炎

Abstract:

Objective To analyze the relationship between different antibody subtypes of Helicobacter pylori （Hp） infection and the pathological characteristics of the stomach，as well as the correlations between serum pepsinogen （PG） Ⅱ，the ratio of pepsinogen Ⅰ-to-pepsinogen Ⅱ（PGⅠ/PGⅡ） and gastrin 17 （G-17） in patients with chronic gastritis and type Ⅰ Hp infection，inflammatory activity，atrophy degree and intestinal metaplasia degree. Methods A retrospective analysis was conducted on 236 patients with benign gastric diseases admitted to the Gastroenterology Department of Zengcheng Branch of Nanfang Hospital of Southern Medical University from July 2022 to February 2024. Among them，78 cases were positive for type Ⅰ Hp antibodies （type Ⅰ Hp infection group），47 cases were positive for type Ⅱ Hp antibodies （type Ⅱ Hp infection group），and 111 cases were negative for Hp antibodies （control group）. All the clinical data and relevant laboratory determination results were collected，and the differences among the groups were compared. By Spearman correlation analysis，the correlations between PG Ⅱ，PGR，G-17 and the activity of gastric inflammation，degree of atrophy （OLGA staging），degree of intestinal metaplasia （OLGIM staging），type Ⅰ Hp infection were evaluated. Results The type Ⅰ Hp infection group was positively correlated with the activity of gastric inflammation，OLGA stage and OLGIM stage （P<0.05）. When the activity of gastric inflammation was grade 3 （+++），the infection rate of the type Ⅰ Hp infection group was 4.9 times that of the type Ⅱ Hp infection group （P<0.05）. When the OLGA stage was stage Ⅲ，the infection rate of the type Ⅰ Hp infection group was 2.1 times that of the type Ⅱ Hp infection group （P<0.05）. When the OLGIM stage was stage Ⅲ，the infection rate of the type Ⅰ Hp infection group was 2.6 times than that of the type Ⅱ Hp infection group （P<0.05）. There was statistical significance in serum PGⅡ，PGR and G-17 levels among control group，type Ⅰ Hp infection group and type Ⅱ Hp infection group （P<0.05）. In patients with chronic gastritis，serum PGⅡ was positively correlated with type Ⅰ Hp infection，the activity of gastric inflammation，the degree of atrophy and the degree of intestinal metaplasia （P<0.05）. Serum PGR was negatively correlated with type Ⅰ Hp infection，the activity of inflammation，OLGA stage and OLGIM stage （P<0.05）. Serum G-17 level was positively correlated with type Ⅰ Hp infection and the activity of gastric inflammation and OLGIM stage（P<0.05）. Conclusions Type Ⅰ Hp infection has an influence on the development of benign gastric diseases，the levels of PGⅡ，PGR and G-17 in chronic gastritis patients are correlated with type Ⅰ Hp infection and gastric pathological changes，such as inflammatory activity，atrophy and intestinal metaplasia.

Key words: Helicobacter pylori, Antibody typing, Chronic gastritis

中图分类号:

R378.99

吴晓琼, 陈东妙, 梁钰敏, 王从容. Ⅰ型和Ⅱ型幽门螺杆菌感染对慢性胃炎的影响[J]. 检验医学, 2025, 40(8): 798-803.

WU Xiaoqiong, CHEN Dongmiao, LIANG Yumin, WANG Congrong. Influence of Helicobacter pylori Ⅰ and Ⅱ infection on chronic gastritis[J]. Laboratory Medicine, 2025, 40(8): 798-803.

图/表 5

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组别	例数	0级（-）/[例（%）]	1级（+）/[例（%）]	2级（++）/[例（%）]	3级（+++）/[例（%）]
Ⅰ型Hp感染组	78	19（24.4）^*	12（15.4）	8（10.3）	39（50.0）^*
Ⅱ型Hp感染组	47	26（55.3）^*#	7（14.9）	6（12.8）	8（17.0）^#
对照组	111	83（75.8）	18（16.2）	5（4.5）	5（4.5）
χ²值		26.490	0.043	3.500	45.250
P值		0.010	0.978	0.174	0.010

组别	例数	0级（-）/[例（%）]	1级（+）/[例（%）]	2级（++）/[例（%）]	3级（+++）/[例（%）]
Ⅰ型Hp感染组	78	19（24.4）^*	12（15.4）	8（10.3）	39（50.0）^*
Ⅱ型Hp感染组	47	26（55.3）^*#	7（14.9）	6（12.8）	8（17.0）^#
对照组	111	83（75.8）	18（16.2）	5（4.5）	5（4.5）
χ²值		26.490	0.043	3.500	45.250
P值		0.010	0.978	0.174	0.010

组别	例数	0期/[例（%）]	Ⅰ期/[例（%）]	Ⅱ期/[例（%）]	Ⅲ期/[例（%）]
Ⅰ型Hp感染组	78	20（25.6）^*	15（19.2）	22（28.2）^*	21（27.0）^*
Ⅱ型Hp感染组	47	25（53.2）^*#	9（19.1）	7（14.9）	6（12.8）^*#
对照组	111	76（68.5）	17（15.3）	18（16.2）	0（0）
χ²值		19.149	0.604	5.322	24.780
P值		0.010	0.739	0.070	0.010

组别	例数	0期/[例（%）]	Ⅰ期/[例（%）]	Ⅱ期/[例（%）]	Ⅲ期/[例（%）]
Ⅰ型Hp感染组	78	20（25.6）^*	15（19.2）	22（28.2）^*	21（27.0）^*
Ⅱ型Hp感染组	47	25（53.2）^*#	9（19.1）	7（14.9）	6（12.8）^*#
对照组	111	76（68.5）	17（15.3）	18（16.2）	0（0）
χ²值		19.149	0.604	5.322	24.780
P值		0.010	0.739	0.070	0.010

组别	例数	0期/[例（%）]	Ⅰ期/[例（%）]	Ⅱ期/[例（%）]	Ⅲ期/[例（%）]
Ⅰ型Hp感染组	78	21（27.0）^*	14（17.9）	17（21.8）	26（33.3）^*
Ⅱ型Hp感染组	47	26（55.3）^*#	8（17.0）	7（14.9）	6（12.8）^*#
对照组	111	78（70.3）	11（10.0）	19（17.1）	3（2.7）
χ²值		18.803	2.533	1.444	28.571
P值		0.010	0.282	0.486	0.010