百色地区居民幽门螺杆菌的毒力及其耐药状况研究  

Investigation of the toxicity and drug fast state of Helicobacter pylori infection in Baise

作　　者：岑朝[1] 黄赞松[1] 周喜汉[1] 梁玉美[1] 尹毅霞[1] 黄明宜[1] 覃红梅[1] 

机构地区：[1]右江民族医学院附属医院消化内科,百色市533000

出　　处：《广西医学》2009年第1期7-10,共4页Guangxi Medical Journal

基　　金：广西百色市科学研究与技术开发计划(百科计字[2006]10号)

摘　　要：目的调查百色地区居民感染幽门螺杆菌(Hp)的细胞毒素相关基因(cagA)、空泡毒素基因(vacA)的流行情况及甲硝唑耐药状况;探讨Hp的cagA、vacA型与胃肠疾病的关系。方法百色地区上腹不适来诊并行胃镜检查的患者中,尿素酶试验阳性者,用免疫印迹法检查Hp的细胞毒素CagA、空泡毒素VacA、尿素酶(Ure)、氮素还原酶(Rdxa)抗体,Ure阳性者确认Hp感染;Rdxa+为对甲硝唑敏感菌株,反之为耐甲硝唑菌株;据CagA和VacA抗体的阳性或阴性以及它们之间不同组合分为若干菌型。结果Hp检出率42.09%(362/860),Hp的CagA、VacA抗体阳性者分别为73.20%(265/362)和60.77%(220/362),根据上述2种检测抗体结果的组合,有3种菌型即CagA+/VacA+、CagA-/VacA-CagA+/VacA-,分别占60.77%、26.80%和12.71%;CagA、VacA抗体和CagA+/VacA+、CagA-/VacA-菌型在胃癌、消化性溃疡、胃炎中的表达分布差异有统计学意义(P=0.000)。规范根除Hp,总根除率86.38%(298/345),CagA+/VacA+与CagA-/VacA-两种菌型根除率比较差异有统计学意义(P=0.031);Rdxa+组和Rdxa-组根除率分别为84.44%(76/90)和87.06%(222/255),比较差异无统计学意义(P=0.534)。Rdxa-菌株占72.93%。结论百色地区上消化道疾病患者感染的幽门螺杆菌以CagA+、VacA+基因型占优势,并且与上消化道疾病严重程度存在显著相关性。推测百色地区甲硝唑耐药率较高。Objective To investigate the popularity state of vacuotoxin-associated gene （vacA） and cytotoxin - associated gene （cagA） in local residents who infected Helicobacter pylri, so do the Arilin drug fast state. Methods The CagA, VacA, Urease and Rdxa antibody were detected by Western blotting in patients applied gastroscopie and urease test showed positive reaction. Urease test positive reaction confirmed Hp infection,to disdinguish Arelin sensitive strain by positive reaction of Rdxa. Germ type were divided by the positive or negative reaction of CagA and VacA antibody. Results The detecting rate of Hp was 42.09% （362/860）, positive reaction rate of Hp CagA and VacA was 73.20% （265/362） and 60.77 % （220/362）. The germ were divided into three types according to the detection： CagA ＋/VacA ＋ （60.77 % ）, CagA -/VacA - （26.80%） and CagA ＋/VacA - （ 12.71% ）. There were significant distributional difference of the expression of CagA,VacA antibody and CagA ＋/VacA ＋ ,CagA -/VacA - germ types in gastric cancer,peptic ulcer and gastritis （P=0.000）. Total eradication rate of Hp was 86. 38% （298/345）, that of Rdxa ＋ group and Rdxa-group was 84. 44% （76/90） and 87. 06% （222/255） ,hasn significant difference （χ^2 = 0. 386,P = 0. 534）. The comparision of CagA ＋/VacA ＋ and CagA -/VacA - has significant difference（χ^2 = 4. 364, P=0.031）. Conclusion In Hp infection of upper digestive tract,gone type CagA ＋ ,VacA ＋ were the major types,and present significant dependability with the severity degrees. Presume that the drug fast rate of Arelin would be high in local residents with the result.

关 键 词：胃肠疾病 幽门螺杆菌感染 幽门螺杆菌 空泡毒素基因 细胞毒素相关基因 壮族 

分 类 号：R378.99[医药卫生—病原生物学]