胆固醇结石、胆囊黏膜和胆汁细菌DNA的检测  

Determination of bacteria DNA in cholesterol gallstones, gallbladder mucosa and bile

作　　者：蔡端[1] 朱雷明[1] 吕元[1] 刘维薇[1] 张延龄[1] 

机构地区：[1]复旦大学医学院附属华山医院外科教研室,上海200040

出　　处：《中华消化杂志》2004年第11期647-650,共4页Chinese Journal of Digestion

基　　金：国家自然科学基金资助项目 (3 0 0 70 73 7)

摘　　要：目的　探讨胆固醇结石中细菌DNA的意义。方法　用半定量PCR和16SrRNA序列分析法检测胆囊黏膜、胆汁和胆石的细菌DNA ,观察围手术期抗生素的使用对检测结果的影响。结果　(1)结石核心、外周、胆汁和胆囊黏膜细菌DNA阳性率分别为79%、82 %、77%和6 4 %。胆石、胆汁和胆囊黏膜间细菌DNA阳性率无相关性。(2 )结石核心、外周、胆汁和胆囊黏膜细菌菌落数对数值(cfu)分别为3.19±2 .0 9、3.2 6±2 .0 5、3.2 3±2 .14和3.2 8±2 .70。结石内外菌落数相关系数为0 .82 2 (P <0 .0 5 )。胆汁和胆囊黏膜菌落数不相关。胆石核心及外周与胆汁和胆囊黏膜菌落数均不相关。(3)术前用与不用抗生素者胆汁、胆囊黏膜、胆石核心和外周的细菌DNA阳性率均差异无显著性。但用抗生素者胆汁菌落数下降,与未用抗生素组比较差异有显著性(P <0 .0 1) ,而胆囊黏膜、胆石核心和外周的菌落数则差异无显著性。(4)胆石、胆汁、胆囊黏膜的细菌DNA序列并不完全相同,胆石核心与外周部位的DNA序列也不相同。结论　胆固醇结石中细菌DNA可能并非胆道环境细菌污染的结果。较之胆汁和胆囊黏膜的细菌DNA ,胆固醇结石中的细菌DNA与结石形成的关系更密切。Objective To clarify the significance of bacteria DNA in cholesterol gallstone. Methods Semi-quantitative PCR and comparative 16S rRNA analysis were used to detect bac teria DNA in gallbladder mucosa, bile and cholesterol gallstones. The influence of peri-operative use of antibiotics on the results of detection was a lso observed. Results (1) The positive rate of bacteria DNA in core and periphery part of gallstones, bile and gallbladder mucosa was 79%, 82%, 77% and 64% respectively, with no posi tive correlation existed among them. (2) The bacteria concentrations in core and periphery part of gallstones, bile and gallbladder mucosa were 3.19±2.09, 3.26 ±2.05, 3.23±2.14 and 3.28±2.70 cfu (log value) respectively. The bacteria con centration in core part of gallstone correlated with those of periphery ones ( r=0.822, P< 0.05). No correlation existed between bile and mucosa bacte ria concentrations. The bacteria concentrations in core or periphery part of gallsto ne did not correlate with those of bile and mucosea. (3) Whether or not using an tibiotics, no differences of bacteria DNA positive rate were observed on core or periphery part of gallstones, bile and mucosa. The bile bacteria concentrations fell significantly after receiving antibiotics in peri-operation period, while no changes on core or periphery part of gallstones and mucosa were observed. (4) The bacteria DNA sequences in gallstones, bile or mucosa were often different, even the sequences between core and periphery of gallstone were heterogeneous. Conclusions The bacteria in cholesterol gallstone may not be the ou tcome of contamination from biliary tract. Compared with the bacteria presented in bile or mucosa, the bacteria in cholesterol gallstone may play a more import ant role in the formation of cholesterol gallstones.

关 键 词：胆囊黏膜 胆汁 细菌DNA 外周 胆石 胆固醇结石 抗生素 DNA序列 显著性 对数 

分 类 号：R575.6[医药卫生—消化系统]