中文摘要：

目的探讨慢性萎缩性胃炎（CAG）合并幽门螺旋杆菌（Hp）感染患者脾胃湿热证与Hp细胞毒相关蛋白A（CagA）、环氧合酶2（Cox-2）及胃黏膜病变程度的相关性。方法纳入经Hp检测、胃镜及病理检查确诊为CAG患者70例,Hp阳性并经中医辨证为脾胃湿热证和脾胃虚寒证的患者各30例,Hp阴性患者10例作为阴性对照组。采用酶联免疫分析法（ELISA）检测患者血清CagA、Cox-2的表达水平,并结合病理结果,分析组间CagA阳性率、Cox-2表达水平及胃黏膜病变程度的差异。结果 CAG合并Hp感染的脾胃湿热证组CagA阳性率、血清Cox-2表达水平高于脾胃虚寒证患者,且均高于Hp阴性组,差异有统计学意义（P〈0.05）;脾胃湿热证胃黏膜病变程度与脾胃虚寒证相比差异无统计学意义（P〉0.05）,但脾胃湿热证具有较轻的趋势。结论 CagA及Cox-2可能参与CAG合并Hp感染患者脾胃湿热证的形成,脾胃湿热证在CAG合并Hp感染早期进展中具有重要作用,为探讨脾胃湿热证在CAG进展中作用机制提供一定的依据。

英文摘要：

Objective To explore the correlation of chronic atrophic gastritis （CAG）with Hp infection of spleen and stomach damp heat pattern/syndrome with cytotoxin - associated gene - a （ Cag A）, cyclooxygenase 2 （ Cox - 2 ） and gastric mucosa disorder. Methods Seventy cases of CAG, diagnosed via Hp determination, gastroseope and pathological examination were included. There were 30 cases for each of Hp positive and spleen and stomach damp heat pattern/syndrome and of Hp positive and spleen and stomach deficiency cold pattern/syndrome. Ten cases of Hp negative were included in the negative control group. ELISA was adopted to determine serum Cag A and Cox -2 expressions. In association with pathological results, Cag A positive rate, Cox -2 expression level and gastric mucosa disorder were compared and analyzed among groups. Results In CAG plus Hp infection spleen and stomach damp heat group, Cag A positive rate and serum Cox - 2 expression were higher than those in spleen and stomach deficiency cold group, and the results in the two groups were all higher than those in Hp negative group, indicating the significant difference （P 〈 0.05 ）. The difference in gastric mueosa disorder severity was not significant between spleen and stomach damp heat group and the spleen and stomach deficiency cold group （P 〉 0.05 ） , but the condition was mild in tendency in the spleen and stomach damp heat group. Conclusion Cag A and Cox -2 are possibly involved in the formation of spleen and stomach damp heat pattern/syndrome in the patients of CA（; and Hp infection. The spleen and stomach damp heat pattern/syndrome plays the important role in the early progression of CAG with Hp infection, which provides a certain evidence on the exploration of the effect mechanism of spleen and stomach damp heat pattern/syndrome in the progression of CAG.