淮南地区矿工幽门螺杆菌vacA、cagA基因分布特征  

Investigation into the Distribution of vacA and cagA Genes of Helicobacter Pylori in Miners of Huainan City

作　　者：汪雪峰[1] 崔玉宝[2] 王钧[3] 王克霞[1] 陈琳[1] 吴静[1] 胡友莹[1] 

机构地区：[1]安徽理工大学医学院,淮南232001 [2]海南医学院,海口571101 [3]淮南第二矿工医院,淮南232052

出　　处：《环境与职业医学》2006年第6期496-498,503,共4页Journal of Environmental and Occupational Medicine

基　　金：安徽省教育厅自然科学研究项目(编号:2003kj111)

摘　　要：[目的]研究淮南地区煤矿工人幽门螺杆菌(Helicobacterpylori,H.pylori)vacA、cagA基因分布特征。[方法]选择经胃镜及病理组织检查诊断证实有相关胃、十二指肠疾病的349名矿工为研究对象,取其胃窦部活检黏膜作H.pylori的分离培养,利用聚合酶链反应技术(PCR)测定分离培养出H.pylori菌株的vacA、cagA基因,并进行分型。[结果]349份样本中共分离培养出244株H.pylori菌株,其中慢性胃炎、萎缩性胃炎、胃溃疡及十二指肠溃疡幽门螺杆菌培养阳性率分别为61.61%(69/112)、61.54%(48/78)、75%(72/96)及87.30%(55/63);基因测定结果显示,244株H.pylori菌株临床分离株中,84.84%(207/244)含vacA基因,73.36%(179/244)含cagA基因;其中慢性胃炎、萎缩性胃炎、胃溃疡及十二指肠溃疡cagA、vacA基因检出率分别为66.67%(46/69)、50.72%(35/69)、85.42%(41/48)和70.83%(34/48)与93.06%(67/72)、84.72%(61/72)、96.36%(53/55)和89.09%(49/55),4种疾病间差异均具显著性(P<0.01)。进一步分型发现,慢性胃炎、萎缩性胃炎,胃溃疡及十二指肠溃疡患者中vacA+、cagA+分别为44.93%(31/69)、66.67%(32/48)、79.17%(57/72)、87.27%(48/55),差异具显著性(χ2=30.80,P<0.01)。vacA+、cagA+菌株主要多见于损害较严重的胃黏膜表面,如萎缩性炎症、炎性坏死等,23例腺体不典型增生的胃黏膜表面均为vacA+、cagA+菌株。[结论]淮南地区矿工H.pylori感染多为vacA+、cagA+菌株,vacA+、cagA+H.pylori菌株为高毒力菌株,且与较严重的胃黏膜病理改变有关,可能是导致矿工慢性胃炎、消化性溃疡的重要因素,临床应充分重视H.pylori菌株毒力因子的监测。[ Objective ] To investigale the distribution of vacA and cagA genes of Helicobacter pylori in miners of Huainan City. [ Methods ] Gastroscopy was performed in 349 miners with gztstrointestinal symptoms, and gastric biopsy specimens were obtained from gastric antrum and used for isolation of H.pylori. The types of vacA and cagA genes of H.pylori were determined by using polymerase chain reaction （ PCR ）. [ Results ] A total of 244 H.pylori isolates were obtained from 349 miners, and the detection rates of in chronic gastritis cases, atrophic gastritis, gastric ulcer and duodenal ulcer cases were 61.61% （ 69/112 ）, 61.54%（ 48/78 ）, 75%（ 72/96 ）and 87.30%（ 55/63 ）, respectively. Of the 244 H.pylori strains, 84.84%（ 207/244 ） hayer vacA gene and 73.36%（ 179/244 ）have cagA gene. The detection rates of vacA and cagA genes in chronic gastritis, atrophic gastritis, gastric and ulcer duodenal ulcer cases were 66.67%（ 46/69 ） and 50.72%（ 35/69 ）, 85.42%（ 41/48 ） and 70.83%（ 34/48 ）, 93.06% （ 67/72 ） and 84.72% （ 61/72 ）, 96.36% （ 53/55 ） and 89.09% （ 49/55 ）, respectively. Compared between diseases there was significant difference （P 〈 0.01 ）. Further genotype analysis found thai 44.93% （ 31/69 ）, 66.67% （ 32/48 ）, 79.17% （ 57/72 ）, 87.27%（ 48/55 ）of patients with chronic gastritis, atrophic gastritis, gastric ulcer and duodenal ulcer infected with H.pylori were with vacA＋, cagA＋ genolypes, respectively（x^2 = 30.80, P 〈 0.01 ）. H.pylori strains with vacA＋ and cagA＋ genotyps were more observed in gastric mucosa with severe inflammation, such as atrophic and necrosis inflammation. Furthermore, 23 patients with dysplasia were all infected by H.pylori with vacA＋ and togA＋ strains. [ Conclusions ] The H.pylori infection in Huainan miners is mostly with vacA＋, cagA＋ strains, and the H.pylori strains with ratA＋ and cagA＋ are highh virulent, and related to the changes of severe pathological type of gastric mucosa, which may

关 键 词：矿工 幽门螺杆菌 CAGA基因 VACA基因 胃肠道疾病 

分 类 号：R573.9[医药卫生—消化系统]