云南汉、白、纳西族人群幽门螺杆菌vacA基因m混合亚型及iceA基因混合型的致病性研究  

Infection of Helicobacter pylori strains with multiple vacA m-region subtypes and/or iceA mixed genotype among the Bai,Naxi,and Han populations in Yunnan province

作　　者：周曾芬[1] 代薇[1] 张建中[2] 南琼[1] 张静祎[1] 王健[1] 金利[1] 和泽元 陶中原 木金花 

机构地区：[1]昆明医学院第一附属医院消化内科,650032 [2]中国疾病预防控制中心传染病预防控制所 [3]云南丽江县医院 [4]云南大理州医院 [5]云南丽江地区医院

出　　处：《中华医学杂志》2005年第34期2408-2413,共6页National Medical Journal of China

基　　金：云南省教委自然科学基金资助项目(0012332)

摘　　要：目的探讨云南白族、纳西族与汉族幽门螺杆菌(H.pylori)菌株含有vacA基因m混合亚型及iceA基因混合型的感染情况及其致病性。方法选取H.pylori相关慢性胃炎和消化性溃疡患者的胃黏膜,分离培养H.pylori菌株;用PCR方法检测云南白族、纳西族与汉族菌株的vacA基因亚型及iceA基因。结果云南109例H.pylori菌株的混合感染率为32.1%。iceA混合基因亚型的检出率明显高于vacA基因m混合亚型检出率(均P<0.05)。其中白族混合感染率(67.7%)高于纳西族(20.0%)和汉族(12.1%)(均P<0.001);白族中iceA1+iceA2的混合感染率(61.3%)明显高于纳西族(17.8%)和汉族(9.1%)(均P<0.001)。云南菌株34例H.pylori混合感染患者中含vacA基因m混合亚型+iceA混合基因型的混合感染与消化性溃疡有关;只含iceA混合基因亚型的混合感染与慢性胃炎有关。结论不同国家和地区的混合感染率差别很大,云南白族、纳西族与汉族H.pylori菌株含有vacA基因m混合亚型及iceA混合基因型者的混合感染具有多态性。汉族以vacA基因混合亚型来判断混合感染较敏感,白族、纳西族患者中以iceA基因混合亚型判断混合感染较敏感。云南H.pylori菌株含iceA基因亚型和含vacA基因m混合亚型以及白族菌株的vacA基因m区亚型的混合感染与H.pylor致病性有关;以iceA基因混合亚型判断混合感染较敏感。Objective To study the epidemiology and pathogenicity of mixed infection of Helicobacter pylori （H. pylori ） strains with multiple vacA m-region subtypes and/or iceA mixed genotype among the Bai, Naxi, and Han populations in Yunnan province. Methods Gastric mucous membrane were obtained by gastroscopy from 444 patients with digestive ulcer or chronic gastritis, 165 of Han nationality, 117 of Bai nationality, and 162 of Naxi nationality. H. pylori was isolated from 109 patients and cultured. RT-PCR was used to detect the Helicobacter pylori strains vacA gene subtype and iceA genes. Results The overall rates of vacA gene sl type and vacA gene s2 type were 98.2% （107/109） and 1.8% （2/109） respectively. The overall rates of vacA gene m2 type, vacA gene mla type, vacA gene mlb type, and mixed types were 45.9% （ 50/109 ）, 0.9% （ 1. 109 ）, 23.9% （ 26/109 ）, and 11% （ 12/109 ） respectively; and m region was not identified in 18.3% （20/109） of the strains. The overall rates of iceA1 and iceA2 genes were 67.0% （73/109） and 41.3% （45/109） respectively. In the specimens from the patients of Bai nationality, as regards the s region, only sl type was identified in all specimens; the rates of vacA gene m2 type, vacA gene mla type, vacA gene mlb type, and mixed type were 45.2% （ 14/31 ）, 3.2% （ 1/31 ）, 12.9% （4/31 ）, and 16.2% （5/31 ） respectively, and m region was not identified in 22.6% of the strains ; and the rates of iceA1 and iceA2 were 87. 1% （ 27/31 ） and 61.3% （ 19/31 ） respectively. In the specimensfrom the patients of Naxi nationally, The rates of vacA gene sl type and s2 type were 95.6% （43/45）and 4. 4% （2/45） , the rates of vacA gene m2 type, vacA gene mlb type, and mixed m -type were 33.3% （ 15/ 45）, 37. 8% （17/45）, and 6. 7% （3/45） respectively, no mla type was found, and m region was not identified in 22. 2% of the strains ; the rates of iceA l and iceA2 were 48.9% （ 22/45 ） and 31. 1% （ 14/45 ） respectively. In the specim

关 键 词：螺杆菌 幽门 胃炎 胃溃疡 基因 细菌 ICEA基因 VACA基因 群幽门螺杆菌 致病性研究 基因亚型 云南白族 

分 类 号：R378[医药卫生—病原生物学]