The Clinical Application Value Of Helicobacter Pylori Antibody Subtype In Upper Gastrointestinal Diseases

Objective:To investigate the clinical application valve of Helicobacter Pylori?Hp?Antibody Subtype Assay[CagA-Ab,VacA-Ab,UreA-Ab,UreB-Ab]in upper gastrointestinal diseases in South Fujian.Methods:Retrospective analysis of the distribution of Hp antibody typing in 1356patients with gastrointestinal disease or physical examination by immunoblotting;65patients with simultaneous detection of ¹³C-UBT and Hp urease antibody?colloidal gold method?for Hp diagnosis efficacy evaluation;110 patients with Hp current infection who were simultaneously tested for Hp antibody typing and positive for¹³C-Urea Breath Test were divided into peptic ulcer and non-peptic ulcer group to analyze whether there were statistical differences in distribution of type?and type?low-virus strains between two groups.Of these 12 patients who took proton pump inhibitors for a long period of time and had not undergone H.pylori eradication therapy,H.pylori antibody typing was repeated at intervals of more than 3 months,and changes in antibody typing were analyzed.Results:In 1356 patients undergoing Hp antibody subtype assay,the Hp infection rate was as high as 72.3%.Among all the infected persons,the proportion of patients with type I high-risk strains was 48.3%,and the proportion of patients with low-risk?strains was 51.7%,with the latter exceeding 1/2.By analyzing the results of two serological Hp urease antibody tests in 65 patients,Hp antibody typing has a higher detection rate of Hp infection?P<0.05?.The diagnostic sensitivity for Hp current infection is 97.6%and the specificity is 54.2%.Among 328 cases of upper gastrointestinal disease,there was no significant difference in the distribution of Hp antibody type between PU,GC,CAG groups and CNAG group?P>0.05?.The positive rates of type?strains in the duodenal ulcer group and chronic non-atrophic gastritis group were more than 50%in 110 patients with Hp current infection,P>0.05;Compared with gastric cancer group and duodenal ulcer group,P>0.05;Gastric cancer group and chronic non-atrophic gastritis group were compared,P>0.05.The110 patients were divided into peptic ulcer group and non-peptic ulcer group.There was no significant difference in antibody type distribution between the two groups?P=0.116>0.05?,and as for"CagA-Ab+,?CagA-Ab+,VacA-Ab+?,?CagA-Ab-,VacA-Ab-?",there was no statistically significant difference in the three different subtypes distribution?P>0.05?.Subsequent follow-up was performed on non-peptic ulcer patients?excluding patients with gastric cancer?.Follow-up duration was 4 to12 months.Thirty-four patients who had not undergone Hp eradication treatment or eradication failure were grouped by exposure to type?and type?antibodies.There was no significant difference in the distribution of ulcer incidence?P>0.05?.For patients taking proton pump inhibitors for a long period of time,there was no change in Hp antibody typing after 3 months without Hp eradication therapy.Conclusion:Hp antibody typing was detected by Western blotting,whose UreB-Ab?66KD band?and UreA-Ab?30KD band?were detected at the same time.So its detection rate of Hp infection was higher than that of urease antibody?colloidal gold method??P<0.05?.There is a certain significance in epidemiological screening.Chinese people generally infect Hp,and the proportion of patients with type?low-risk strains defined by antibody typing may exceed 1/2;Serum antibodies can still be maintained for a long time after the treatment of Hp eradication.the Hp antibody typing test has a low specificity for the diagnosis of Hp current infection,and the clinical application value is limited.The detection of serum CagA-Ab and VacA-Ab to define the type of Hp strain for predicting the consequences of Hp infection is limited,and the cost is relatively expensive.It is not recommended as a prediction of the virulence of Helicobacter pylori,and it is not recommended to carry out general clinical hospitals.For patients taking long-term proton pump inhibitors,the type of Hp strain colonized in the stomach may not change without Hp eradication therapy.