幽门螺杆菌感染对儿童胃黏膜闭锁小带蛋白表达的影响

Effects of Helicobacter pylori Infection on the Expression of Zonula Occludens in Gastric Mucosa in Children

摘要: 目的：探讨幽门螺杆菌(Helicobacter pylori, Hp)血清抗体分型、¹³C尿素呼气试验(¹³Curea breath test, ¹³C-UBT)超基准值(delta over baseline, DOB)及儿童胃黏膜闭锁小带蛋白-1 (zonula occludens-1, ZO-1)之间的相互关系。方法：选取2018年02月~2020年11月因“恶心、呕吐、腹痛、黑便、面色苍黄”等症状就诊于青岛大学附属医院并确诊为Hp感染的77例患儿作为研究对象。采用SP免疫组织化学半定量法检测胃黏膜组织ZO-l蛋白含量；利用蛋白质芯片法检测Hp血清抗体阳性表达情况，并将Hp感染分为三型；行13C-UBT得到患儿DOB值，并根据DOB值大小将77例Hp感染患儿分为3组。分析Hp血清抗体分型、不同DOB值及ZO-1蛋白之间的相互关系。结果：1) I型ZO-1蛋白的阳性表达率为15.217%，中间型ZO-1蛋白的阳性表达率为20.000%，II型ZO-1蛋白的阳性表达率为56.250%，ZO-1蛋白表达在不同血清型Hp感染组中表达存在差异，I型 < 中间型 < II型，差异有统计学意义(X² = 9.740，P < 0.01)；2) I型中DOB不同分组所占的比例为1组23.913%、2组32.609%、3组43.478%，II型中DOB不同分组所占的比例为1组18.750%、2组62.500%、3组18.750%，中间型中DOB不同分组所占的比例为1组46.667%、2组33.333%、3组20.000%，差异无统计学意义(X² = 7.914，P > 0.05)；3) DOB值1组ZO-1蛋白的阳性表达率为23.810%，2组ZO-1蛋白的阳性表达率为33.333%，3组ZO-1蛋白的阳性表达率为15.385%，差异无统计学意义(X² = 2.364，P > 0.05)。结论：不同Hp血清抗体分型中ZO-1蛋白表达水平不同，Hp抗体分型与黏膜损伤程度相关，可用于评估感染Hp后黏膜损伤程度，但DOB值与黏膜损伤程度无关。

Abstract: Objective: To investigate the relationship between serum antibody typing of Helicobacter pylori (Hp), ¹³C urea breath test (¹³C-UBT) reference value (delta over baseline, DOB) and zonula occludens-1 (ZO-1) of gastric mucosa in children. Methods: Seventy-seven children diagnosed with Hp infection in the Affiliated Hospital of Qingdao University from February 2018 to November 2020 due to nausea, vomiting, abdominal pain, melena, pale complexion and other symptoms were selected as the study subjects. The protein content of Zo-1 in gastric mucosa was detected by SP immunohistochemistry semi-quantitative method; the positive expression of Hp serum antibody was detected by protein chip method, and Hp infection was divided into three types. DOB value was obtained by 13C-UBT, and 77 children with Hp infection were divided into 3 groups according to DOB value. The relationship between Hp serum antibody types, DOB values and ZO-1 protein was analyzed. Results: 1) The positive expression rate of type I ZO-1 protein was 15.217%, that of intermediate ZO-1 protein was 20.000%, and that of type II ZO-1 protein was 56.250%. There were differences in the expression of ZO-1 protein in different serum types of Hp infection groups, with type I < intermediate < type II, and the difference was statistically significant (X² = 9.740, P< 0.01); 2) The proportion of DOB in different groups of type I was 23.913% in group 1, 32.609% in group 2 and 43.478% in group 3. The proportions of different DOB groups in type II were 18.750% in group 1, 62.500% in group 2 and 18.750% in group 3. The proportions of different DOB groups in intermediate type were 46.667% in group 1, 33.333% in group 2 and 20.000% in group 3, showing no statistical significance (X² = 7.914, P > 0.05); 3) The positive expression rate of ZO-1 protein in group 1, group 2 and group 3 was 23.810%, 33.333% and 15.385%, respectively, with no statistical significance (X² = 2.364, P > 0.05). Conclusions: The expression level of ZO-1 protein was different in different Hp serum antibody types, and Hp antibody type was correlated with the degree of mucosal damage, which could be used to evaluate the degree of mucosal damage after infection with Hp, but DOB value was not related to the degree of mucosal damage.