Epidemiological Investigation Of H.pylori Infection On The Patients With Chronic Gastropathy And Analysis Of The Influencing Factor Of Eradication Therapy

PART â… Epidemiological Investigation of H.pylori Infection on the Patients withChronic Gastropathy and the Influence of the Different VirulenceSubtypes on Clinic Characteristics of Chronic GastropathyObjective we made a large sample of epidemiologicalinvestigation of chronic gastropathic patients in native region. In orderto analyze prevalence of H.pylori infection and relationship between theprevalence of H.pylori infection and age,sex. Evaluate the relationshipbetween the serum antibodies detected rates of different virulencesubtypes and different diseases ,pathohistologic morphous of gastricmucosa.Methods 3158 Patients with chronic gastropathy were detected byHp-IgG,RUT or 14C-UBT. 621patients were tested by pathohistologicassay. 944 Patients with Serum positive of H.pylori infection weredetected by immunoblotting.Results The prevalence of H.pylori infection was 67.73% in nativeregion. The prevalence of H.pylori infection is rather high in nativeregion and increase gradually by the growth of age. There is nodependability with regard to sex in the patients of H.pylori infection. Theserum prevalence of H.pylori infection was respectively 46.80%,78.86% , 86.92 % , 95.29 % and 56.59% with chronic superficialgastritis(CSG),chronic atrophic gastritis(CAG), duodenal ulcer(DU) ,gastric ulcer(GU) and gastric cancer(GC). The serum prevalence ofH.pylori infection among patients with CAG , DU and GU wassignificantly higher than that among patients with CSG and GC( P<0.05 ) .Incidence rates of chronic inflammation , activeinflammation , atrophy and intestinal metaplasia with the H.pyloriinfection were significantly higher than that without H.pylori. The serumantibodies detected rates of different virulence subtypes of CagA andVacA from H.pylori infection were determined by Westen-Blot in 944patients with H.pylori infection.In order to evaluate the relationshipbetween the serum antibodies detected rates of different virulencesubtypes and different chronic gastrophies, the serum antibody wasdetected.We found that the rate of CagA+,VacA+ was respectively58.27%,67.12%,91.81%,81.10% and 88.24% with CAG,CSG,DU,GU and GC;The serum antibody rate of CagA-,VacA-wasrespectively 23.38%,15.07%,3.02%,8.53%and 3.92% with CAG,CSG,DU,GU and GC;While the serum antibody rate of CagA+,VacA-/CagA-,VacA+ was respectively 18.35%,17.81%,5.17%,10.37% and 7.84% with CAG,CSG,DU,GU and GC. We analyzed therelationship between pathologic morphous of gastric mucosa and theserum antibodies rates of different virulence subtypes. The resultsuggested that the serum antibody rate of CagA+,VacA+ was high intotal rate of H.pylori infection .The result showed there was a positivecorrelation between the serum antibody rate of CagA+,VacA+ and theextent of H.pylori density,active inflammation,intestinal metaplasia.There was non-correlation between the serum antibodies rates ofCagA-,VacA-or CagA+,VacA-/ CagA-,VacA+ and different pathologicmorphous of gastric mucosa.Conclusions The prevalence of H.pylori Infection is rather high innative region. And increase gradually by the growth of age. There is nodependability with regard to sex on the patients of infection H.pylori.The serum prevalence of H.pylori infection among patients with CAG,DU and GU is significantly higher than that among patients with CSGand GC. Incidence rates of chronic inflammation,active inflammation,atrophy and intestinal metaplasia with H.pylori infection are significantlyhigher than that without H.pylori. The serum antibody rate of type â… from H.pylori is high,It is important role in mechanism of action with UCand GC, especially DU. There is a positive correlation between theserum antibody rate of typeâ…  and extent of H.pylori density,activeinflammation,intestinal metaplasia.PARTâ…¡Analysis of Relationship between the Different Virulence Subtypes withH.pylori Infection and Eradication TherapyObjective To observe the eradication rate of serum antibodies ofdifferent virulence subtypes with H.pylori infection before-and 4 weeksafter eradication therapy and to evaluate relationship between theserum eradication rate and efficacy on healing of eradication therapy.Methods 944 patients with H.pylori infection received tripleeradication therapy. After 4 weeks ,the patients received 14C-UBT.While we tested the antibodies of different virulence subtypes by themethod of Westren Blot assay for 258 patients follow-up. 394 patientswere tested by pathohistologic assay .Results The eradication rate was respectively 72.57%,11.76%and 16.33% in patients with the serum antibody of CagA+,VacA+,CagA-,VacA-and CagA+,VacA-/CagA-,VacA+.It suggested theeradication rate of the serum antibody of CagA+,VacA+ was prominenthigher than that of CagA-,VacA-and CagA+,VacA-/CagA-,VacA+( P<0.01 ) .We evaluated the relationship between the rate ofdisappearance of upper gastrointestinal symptom and the serumantibodies of different virulence subtypes. It showed the rate ofdisappearance was 50.78% in all. The rate of disappearance wasrespectively 66.29%,8.82% and 24.49% in patients with the serumantibody of CagA+,VacA+,CagA-,VacA-and CagA+,VacA-/CagA-,VacA+.It suggested the rate of disappearance of CagA+,VacA+ in serumwas outstanding higher than that of CagA-,VacA-and CagA+,VacA-/CagA-,VacA+(P<0.01). We also analyzed the relationshipbetween pathologic morphous of gastric mucosa and the rates ofdisappearance of the serum antibodies of different virulence subtypes.The result showed there was significantly correlative between theeradication of H.pylori and the mucosal morphous of H.pylori density,active inflammation and intestinal metaplasia. The rate of eradicationhad positive relation with Mucosal morphous of active inflammation,while the rate of eradication had negative relation with mucosalmorphous of H.pylori density and intestinal metaplasia. There was nocorrelative between the eradication rate and the pathologic morphousof gastric mucosa .Conclusions The eradication rate is rather high in patients with theserum antibodies of CagA+,VacA+.It suggests typeâ… from H.pylori hassensitivity to the eradication therapy. There is a significant correlativitybetween the eradication and the pathologic morphous of gastricmucosa. The rate of eradication has positive relation with Mucosalmorphous of active inflammation ,while the rate of eradication hasnegative relation with mucosal morphous of H.pylori density andintestinal metaplasia .It is important that the chronic gastropathicpatients shall be tested by the method of Westren Blot assay beforeeradication therapy.