支气管哮喘并发幽门螺杆菌感染患儿粪便抗原与血清抗体特征分析
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摘要
目的了解支气管哮喘(哮喘)并发幽门螺杆菌感染患儿幽门螺杆茵(HP)感染情况、免疫表型及其血清型的分布特征。方法收集2016年12月～2017年12月支气管哮喘患儿与同龄健康体检儿童的14 C-BUT检测结果,并收集两组人群的粪便与血清样本,分别采用粪便HP抗原和血清HP抗体检测,比较其与14 C-BUT对于儿童HP感染检测结果之间的差异;采用三种HP诊断方法(14 C-BUT,粪便HP抗原,血清HP抗体检测)筛查两组HP感染,比较各组间HP感染的阳性率是否存在差异;另外,对血清HP抗体阳性的哮喘和健康体检儿童,进一步采用HP血清抗体谱进行分析,以了解哮喘并发HP感染儿童HP血清抗体谱的分布,并比较分析两组间抗体谱及血清型分布差异。结果通过在哮喘和健康体检儿童中三种HP诊断方法比较,三者间的差异无统计学意义(χ~2=1.06,0.77,0.72,均P>0.05),在支气管哮喘与健康体检儿童中HP感染率分别为:30.4%～32.6%和35.4%～37.4%,两组间差异无统计学意义(P>0.05),HP抗体阳性哮喘患儿和健康体检儿童中各抗体谱阳性率为:抗VacA-95KD(31.8%,50.9%),VacA-91KD (31.8%,50.9%),UreA-66KD(65.9%,54.5%),UreB-30KD(63.6%,52.7%),其抗体的阳性率在两组之间差异无统计学意义(χ~2=3.64,3.64,1.31,1.19,均P>0.05);仅CagA-116KD抗体阳性率(36.4%,56.4%)在两组间差异具有统计学意义(χ~2=3.92,P<0.05)。另外I型和Ⅱ型HP感染率在两组中的百分比分别为:哮喘组Ⅰ型36.4%(16/44)和Ⅱ型63.6%(28/44),健康体检组Ⅰ型56.4%(31/55)和Ⅱ型43.6%(31/55),两组间差异存在统计学意义(χ~2=3.92,P<0.05)。结论哮喘的发病率与HP的感染率无直接联系,但其与抗-CagA抗体的阳性率存在明显的负相关,且具有特定的血清型和抗体谱分布特征,这为我们进一步研究哮喘与HP感染的内在联系奠定了理论基础。
Objective To investigate the distribution of Helicobacter pylori(HP)infection,immunophenotype and serotype in children with bronchial asthma and Helicobacter pylori infection.Methods From December 2016 to December 2017,the results of 14 C-BUT test in bronchial patients and healthy children of the same age were collected,and the stool and serum samples of the two groups were collected.Stool HP antigen and serum HP antibody were used to detect by the different ways,and compared with the results of 14 C-BUT test in children.In order to,understand the distribution of HP serum antibody spectrum in children,and to study the difference of antibody spectrum and serotype distribution between the two groups.Results There were no significant difference among the three diagnostic methods of HP(χ~2=1.06,0.77,0.72,all P>0.05).The infection rates of HP were 30.4% ～32.6% and 35.4% ～37.4% in children with bronchial asthma and healthy children,respectively.There was no significant difference between the two groups(P>0.05).The positive rates of anti-VacA-95 KD(31.8%,50.9%),VacA-91 KD(31.8%,50.9%),UreA-66 KD(65.9%,54.5%)and UreB-30 KD(63.6%,52.7%)were not significantly different between the two groups(χ~2=3.64,3.64,1.31,1.19,all P>0.05).The positive rates of CagA-116 KD antibody(36.4%,56.4%)were significantly different between the two groups(χ~2=3.92,P<0.05).The infection rates of HP type I andⅡ were 36.4%(16/44)and 63.6%(28/44)in asthma group,56.4%(31/55)in physical examination group and 43.6%(31/55)in health examination group,respectively.There was significant difference between the two groups(χ~2=3.92,P<0.05).Conclusion The incidence of bronchial asthma is not directly related to the infection rate of HP,but it is negatively correlated with the positive rate of anti-CagA body,and has specific serotype and antibody spectrum distribution characteristics,which lays a theoretical foundation for further study of the relationship between bronchial asthma and HP infection.
Objective To investigate the distribution of Helicobacter pylori(HP)infection,immunophenotype and serotype in children with bronchial asthma and Helicobacter pylori infection.Methods From December 2016 to December 2017,the results of 14 C-BUT test in bronchial patients and healthy children of the same age were collected,and the stool and serum samples of the two groups were collected.Stool HP antigen and serum HP antibody were used to detect by the different ways,and compared with the results of 14 C-BUT test in children.In order to,understand the distribution of HP serum antibody spectrum in children,and to study the difference of antibody spectrum and serotype distribution between the two groups.Results There were no significant difference among the three diagnostic methods of HP(χ~2=1.06,0.77,0.72,all P>0.05).The infection rates of HP were 30.4% ～32.6% and 35.4% ～37.4% in children with bronchial asthma and healthy children,respectively.There was no significant difference between the two groups(P>0.05).The positive rates of anti-VacA-95 KD(31.8%,50.9%),VacA-91 KD(31.8%,50.9%),UreA-66 KD(65.9%,54.5%)and UreB-30 KD(63.6%,52.7%)were not significantly different between the two groups(χ~2=3.64,3.64,1.31,1.19,all P>0.05).The positive rates of CagA-116 KD antibody(36.4%,56.4%)were significantly different between the two groups(χ~2=3.92,P<0.05).The infection rates of HP type I andⅡ were 36.4%(16/44)and 63.6%(28/44)in asthma group,56.4%(31/55)in physical examination group and 43.6%(31/55)in health examination group,respectively.There was significant difference between the two groups(χ~2=3.92,P<0.05).Conclusion The incidence of bronchial asthma is not directly related to the infection rate of HP,but it is negatively correlated with the positive rate of anti-CagA body,and has specific serotype and antibody spectrum distribution characteristics,which lays a theoretical foundation for further study of the relationship between bronchial asthma and HP infection.
引文
[1]田文静,刘电力,刘惠敏,等.人血清幽门螺杆菌SodB抗体检测与胃癌发生的相关性研究[J].现代检验医学杂志,2018,33(1):22-24.TIAN Wenjing,LIU Dianli,LIU Huimin,et al.Correlative study between detection of human serum Helicobacter pylori sod B antibody and the occurrence of gastric cancer[J].J Mod Lab Med,2018,33(1):22-24.
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[10]陈达伟,江晓肖,戴玉柱,等.幽门螺杆菌粪便抗原纳米金侧流免疫层析快速检测板的研制及应用评价[J].现代检验医学杂志,2013,28(3):75-77.CHEN Dawei,JIANG Xiaoxiao,DAI Yuzhu,et al.Evaluation of the development and application of rapid testing plate with gold nanoparticles lateralflow immunochromatographic for detecting Helicobacter pylori stool antigen[J].J Mod Lab Med,2013,28(3):75-77.
[11]CHANG W L,YEH Y C,SHEU B S.The impacts of H.pylori virulence factors on the development of gastroduodenal diseases[J].J Biomed Sci,2018,25(1):68.
[12]SHEIKH A F,YADYAD M J,GOODARZI H,et al.CagA and vacA allelic combination of Helicobacter pylori in gastroduodenal disorders[J].Microb Pathog,2018,122:144-150.
[13]TSANG K W,LAM W K,CHAN K N,et al.Helicobacter pylori sero-prevalence in asthma[J].Respiratory Medicine,2000,94(8):756-759.
[14]WANG Q,YU C R,SUN Y.The association between asthma and Helicobacter pylori:a meta-analysis[J].Helicobacter,2013,18(1):41-53.
[15]CHEN C,XUN P,TSINOVOI C,et al.Accumulated evidence on Helicobacter pylori infection and the risk of asthma:A meta-analysis[J].Annals of Allergy Asthma&Immunology,2017,119(2):137-145,e2.
[16]HUSSAIN K,LETLEY D P,GREENAWAY A B,et al.Helicobacter pylori-mediated protection from allergy is associated with IL-10-secreting peripheral blood regulatory T cells[J].Frontiers in Immunology,2016,7:71.
[2]SOMILY A M,MORSHED M.An update of laboratory diagnosis of Helicobacter pylori in the Kingdom of Saudi Arabia[J].Journal of Infection in Developing Countries,2015,9(8):806-814.
[3]张忠夫,戴玉柱,金美彤,等.幽门螺杆菌粪便抗原和血清抗体胶体金试验联合检测在体检人群的应用价值[J].现代检验医学杂志,2009,24(4):54-56.ZHANG Zhongfu,DAI Yuzhu,JIN Meitong,et al.Value of combinative application of stool HP antigen and serum HP antibody gold colloid tests in healthy examination crow[J].J Mod Lab Med,2009,24(4):54-56.
[4]吉翔,华芸,张学军.哮喘患儿血清白介素与免疫球蛋白检测的临床意义[J].现代检验医学杂志,2015,30(6):127-129.JI Xiang,HUA Yun,ZHANG Xuejun.Clinical significance of combined detection of serum interleukin and immune globulin in children with asthma[J].J Mod Lab Med,2015,30(6):127-129.
[5]MATRICARDI P M,ROSMINI F,RIONDINO S,et al.Exposure to foodborne and orofecal microbes versus airborne viruses in relation to atopy and allergic asthma:epidemiological study[J].BMJ,2000,320(7232):412-417.
[6]中华医学会儿科学会呼吸学组,《中华儿科杂志》编辑委员会.儿童支气管哮喘诊断与防治指南[J].中华儿科杂志,2008,46(10):745-753.The Subspecialty Group of Respiratory Diseases,the Society of Pediatrics.Chinese Medical Association the Editorial Board,Chinese Journal of Pediatrtics.Guidelines for diagnosis and optimal management of asthma in children[J].Chinese Journal of Pediatrtics,2008,46(10):745-753.
[7]ELITSUR Y,DEMENTIEVA Y,REWALT M,et al.Helicobacter pylori infection rate decreases in symptomatic children:a retrospective analysis of 13years(1993~2005)from a gastroenterology clinic in West Virginia[J].Journal of Clinical Gastroenterology,2009,43(2):147-151.
[8]TEOMAN I,OZMERIC N,OZCAN G,et al.Comparison of different methods to detect Helicobacter pylori,in the dental plaque of dyspeptic patients[J].Clinical Oral Investigations,2007,11(3):201-205.
[9]陈达伟,戴玉柱,金美彤,等.121例体检者幽门螺杆菌感染免疫表型检测及分型结果分析[J].现代检验医学杂志,2010,25(3):79-81.CHEN Dawei,DAI Yuzhu,JIN Meitong,et al.Immunopheno type detecting and typing results of 121individuals with H.pylori infection in healthy examination crowd[J].J Mod Lab Med,2010,25(3):79-81.
[10]陈达伟,江晓肖,戴玉柱,等.幽门螺杆菌粪便抗原纳米金侧流免疫层析快速检测板的研制及应用评价[J].现代检验医学杂志,2013,28(3):75-77.CHEN Dawei,JIANG Xiaoxiao,DAI Yuzhu,et al.Evaluation of the development and application of rapid testing plate with gold nanoparticles lateralflow immunochromatographic for detecting Helicobacter pylori stool antigen[J].J Mod Lab Med,2013,28(3):75-77.
[11]CHANG W L,YEH Y C,SHEU B S.The impacts of H.pylori virulence factors on the development of gastroduodenal diseases[J].J Biomed Sci,2018,25(1):68.
[12]SHEIKH A F,YADYAD M J,GOODARZI H,et al.CagA and vacA allelic combination of Helicobacter pylori in gastroduodenal disorders[J].Microb Pathog,2018,122:144-150.
[13]TSANG K W,LAM W K,CHAN K N,et al.Helicobacter pylori sero-prevalence in asthma[J].Respiratory Medicine,2000,94(8):756-759.
[14]WANG Q,YU C R,SUN Y.The association between asthma and Helicobacter pylori:a meta-analysis[J].Helicobacter,2013,18(1):41-53.
[15]CHEN C,XUN P,TSINOVOI C,et al.Accumulated evidence on Helicobacter pylori infection and the risk of asthma:A meta-analysis[J].Annals of Allergy Asthma&Immunology,2017,119(2):137-145,e2.
[16]HUSSAIN K,LETLEY D P,GREENAWAY A B,et al.Helicobacter pylori-mediated protection from allergy is associated with IL-10-secreting peripheral blood regulatory T cells[J].Frontiers in Immunology,2016,7:71.