Parzecka Monika, Szaflarska-Popławska Anna, Mierzwa Grazyna, Gorzkiewicz Marta, Łuczak Sylwia, Grzybowski Tomasz
Nicolaus Copernicus University, Toruń, Poland.
Pol Merkur Lekarski. 2009 Feb;26(152):105-9.
Helicobacter pylori is one of the most popular bacteria in the world. The H. pylori infection is an etiological factor of permanent changes in inflammatory of stomach mucous membrane, peptic ulcer of the stomach and duodenum disease and stomach cancer or mucosa associated lymphoid tissue from lymphoid tissue of mucous membrane. The strain bacteria which produce the protein CagA and cytotoxin VacA belong to the more pathogenic strains. The most successful method of treatment for H. pylori infection is an eradication of the bacteria.
Was an evaluation of the influence which H. pylori genetic type (type I: CagA-positive, CagA-negative, VacA-positive, VacA-negative) has on efficacy of eradication therapy.
214 of patients over the third year of life with symptoms of dyspepsia, of the upper part of the gastrointestinal tract was performed and H. pylori infection was proved in histopathological or (and) urease test and urea breath test. H. pylori identification was performed using PCR method for biopsy specimens of the gastric mucosa, estimating genetic type of the bacteria (CagA-positive, CagA-negative, VacA-positive, VacA-negative). Triple-drug eradication therapy was introduced. The efficiency of this treatment was checked after 6 weeks with the breath test.
The H. pylori infection was found in 101 patients (47.2%), 33 patients were infected with the strain type I (32.7%) and 68 patients (67.3%) with the strain type II. After the treatment the eradication of the infection was found at 71 patients (70.3%), lack of efficacy in H. pylori infection treatment was found at 30 patients (29.7%). Considerably higher percentage of eradicative infection was shown in the group of patients infected with the type II of H. pylori (76.5% vs. 58.8%, p < 0.04).
The effectiveness of eradication can be influenced by the genetic type of H. pylori. The better effects of eradicative treatment can be expected if one is infected with the strains of smaller virulence.
幽门螺杆菌是世界上最常见的细菌之一。幽门螺杆菌感染是胃黏膜炎症、胃和十二指肠消化性溃疡疾病以及胃癌或黏膜相关淋巴组织淋巴瘤等永久性变化的病因。产生蛋白CagA和细胞毒素VacA的菌株属于致病性更强的菌株。治疗幽门螺杆菌感染最成功的方法是根除该细菌。
评估幽门螺杆菌基因类型(I型:CagA阳性、CagA阴性、VacA阳性、VacA阴性)对根除治疗效果的影响。
对214名3岁以上有消化不良症状的上消化道患者进行检查,通过组织病理学或(和)尿素酶试验及尿素呼气试验证实幽门螺杆菌感染。采用PCR方法对胃黏膜活检标本进行幽门螺杆菌鉴定,评估细菌的基因类型(CagA阳性、CagA阴性、VacA阳性、VacA阴性)。采用三联药物根除疗法。6周后通过呼气试验检查治疗效果。
101名患者(47.2%)发现幽门螺杆菌感染,33名患者(32.7%)感染I型菌株,68名患者(67.3%)感染II型菌株。治疗后71名患者(70.3%)感染被根除,30名患者(29.7%)幽门螺杆菌感染治疗无效。感染II型幽门螺杆菌的患者根除感染的比例明显更高(76.5%对58.8%,p < 0.04)。
幽门螺杆菌的基因类型可能影响根除效果。如果感染的是毒力较小的菌株,有望获得更好的根除治疗效果。