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消化不良患者的胃饥饿素与性别、胃地形和幽门螺杆菌的关系。

Gastric ghrelin in relation to gender, stomach topography and Helicobacter pylori in dyspeptic patients.

机构信息

Department of Gastroenterology and Internal Diseases, Medical University of Lodz, Plac Hallera 1, 90-647 Lodz, Poland.

出版信息

World J Gastroenterol. 2009 Nov 21;15(43):5409-17. doi: 10.3748/wjg.15.5409.

Abstract

AIM

To investigate the level of gastric ghrelin in stomach mucosa of dyspeptic patients in relation to Helicobacter pylori (H pylori) infection, bacterial cytotoxicity, topography and gender.

METHODS

The study comprised 40 premenopausal women (19 H pylori positive) and 48 men (17 H pylori positive) with functional dyspepsia. All gastric biopsy specimens revealed normal mucosa or non-atrophic gastritis. Gastric ghrelin concentration was determined by Enzyme linked immunosorbent assay. The cagA and vacA strains of bacterial DNA were identified by multiplex polymerase chain reaction.

RESULTS

In general, infection with H pylori caused an increase in gastric ghrelin level regardless of gender and stomach topography. Significantly more hormone was present in both, non-infected and H pylori positive female samples, as compared to males. The distribution of bacterial strains showed cagA(+) vacA s1m1 and cagA(-) vacA s2m2 genotypes as the most common infections in the studied population. A tendency to higher ghrelin levels was observed in less cytotoxic (cagA negative) strain-containing specimens from the antrum and corpus of both gender groups (without statistical significance).

CONCLUSION

An increase in gastric ghrelin levels at the stage of non-atrophic gastritis in H pylori positive patients, especially in those infected with cagA(-) strains, can exert a gastroprotective effect.

摘要

目的

研究消化不良患者胃黏膜中胃饥饿素的水平与幽门螺杆菌(H pylori)感染、细菌细胞毒性、部位和性别之间的关系。

方法

本研究包括 40 名绝经前妇女(19 名 H pylori 阳性)和 48 名男性(17 名 H pylori 阳性),均患有功能性消化不良。所有胃活检标本均显示正常黏膜或非萎缩性胃炎。通过酶联免疫吸附试验测定胃饥饿素浓度。采用多重聚合酶链反应鉴定细菌 DNA 的 cagA 和 vacA 株。

结果

一般来说,无论性别和胃部位置如何,感染 H pylori 都会导致胃饥饿素水平升高。与男性相比,未感染和 H pylori 阳性的女性样本中激素含量明显更高。细菌株的分布显示 cagA(+) vacA s1m1 和 cagA(-) vacA s2m2 基因型是研究人群中最常见的感染。在男女两组的胃窦和胃体中,含有低细胞毒性(cagA 阴性)菌株的标本中,胃饥饿素水平升高的趋势更为明显(无统计学意义)。

结论

在 H pylori 阳性患者的非萎缩性胃炎阶段,胃饥饿素水平升高,特别是在感染 cagA(-)菌株的患者中,可能发挥胃保护作用。

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