Study On The Relationship Between Helicobacter Pylori Virulences And Children’s Gastric Mucosal Pathology

Objective To study on the relationship between Helicobacter pylori virulences andchildren’s gastric mucosal pathology.Methods A total of175children with upper abdominal discomfort were recruited inthis study,endoscopy was carried out on all the subjects,and124of them werediagnosed to be chronic superficial gastritis,17were gastroduedenal ulcer, and34werediagnosed both. H.pylori infection was determined on rapid urease test,Warthin-Starrysilver staining, and HE staining. using the Western blot to determine it’s phenotype,combined with histopathological staining and gastroscopy to determine whether thestrain type of H.pylori have the Correlation with the gastric mucosal pathology.Results (1) The total rate of CagA and VacA proteins were83.43%(146/175),86.86%(152/175) in the175cases of children, of which the detection rate of CagA in the CSGand GU respectively76.58%,96.08%, significantly higher in GU (P <0.05); of whichthe detection rate of VacA in the CSG and GU detection were respectively88.61%,90.20%, no significant difference between them(P>0.05);(2) in175cases of H.pyloriinfection in children, both of CagA and VacA positive (type I bacteria) accounted for171(81.82%), when both were negative (type II bacteria) accounted for19(9.09%),while VacA or CagA only one positive (intermediate type) accounted for19(9.09%);(3)totally146cases of CagA protein-positive patients,126cases in the acute active state,the mild one accouts for24(19.05%), while the moderate and severe one accouts for102(80.95%), the difference was statistically significant (X2=8.62, P <0.05);119casesof mucosal inflammatory lesions, which manifested as mild were21(17.65%) cases,moderate and severe were98(82.35%) cases, the difference was also statisticallysignificant (X2=6.78, P <0.05).(4)30.82%of the incidence of lymphoid follicles(45/146) was detected in the CagA+group of146cases,while13.79%(4/29) wasdetected in the CagA-group, both of which were of no statistical significance (X2=3.48, P>0.05); intestinal metaplasia incidence of6.16%(9/146) was caculated in CagA +group, while3.45(1/29) was calculated in the CagA-group, which is also of nostatistically significant (X2=0.33, P>0.05).(5)on the activity of inflammation,0%(0/20) of the incidence of lymphoid follicles happened in unactivegastritis,while13.51%(5/37)of incidence of lymphoid follicles in the37cases of mildactive inflammation, and37.29%(44/118). in the moderate to severe activeinflammation, the incidence of Lymphoid follicles maybe performanced for moderateto severe> mild> unactive inflammation,the difference between groups was statisticallysignificant (p <0.05).Conclusion (1) CagA protein has a close relationship with GU, was significantly higherthan that of the CSG; VacA protein can not be used as a characteristics of indicator todistinguish the difference between CSG and GU, but both CagA and VacA contributeto CSG and GU disease.(2) type I strain of Helicobacter pylori was more common inour region,which should be paid more attention;(3) CagA protein can be used asauxiliary diagnostic tool on the diagosing the degree of mucosal inflammation,especially for special groups of children;(4) CagA protein may be nothing to do withlymphoid follicles and intestinal metaplasia.(5) the incidence of lymphoid follicles inH.pylori-related gastrointestinal diseases may be related to degree of activity in chronicgastritis, which performance as follows: moderate to severe> mild> unactiveinflammation.