贵州省某院幽门螺杆菌致病性的优势基因型特征  

The characteristics of dominant genotype of pathogenic Helicobacter pylori in a hospital of Guizhou province

作　　者：李大欢[1] 刘苓[1] 刘娅琳[1] 周力[1] 车筑平[2] 谭庆华[2] 

机构地区：[1]贵阳医学院附属医院消化内科,贵阳550004 [2]贵阳医学院附属医院内镜科,贵阳550004

出　　处：《重庆医学》2013年第5期504-507,共4页Chongqing medicine

基　　金：贵州省优秀科技教育人才省长专项资金资助项目(2008-94)

摘　　要：目的研究贵州省幽门螺杆菌(H.pylori)的CagA、VacA、iceA基因及其不同组合对H.pylori感染结局的影响,明确H.pylroi优势致病基因型的特征。方法于该院门诊收集有上腹部不适症状患者178例,筛选出50例临床菌株,其中慢性非萎缩性胃炎(28例),消化性溃疡(22例),用聚合酶链反应(PCR)扩增DNA检测CagA、VacAs1、VacAs2、VacAm、iceA1、iceA2,经琼脂糖凝胶电泳及测序对以上产物进行检测,BLAST分析与标准菌株的差异性,用χ2检验以及Fisher精确检验分析各基因及其不同组合与临床疾病的相关性。结果 50例菌株CagA、VacAs1、VacAs2、VacAm、iceA1、iceA2基因阳性率分别为92%、94%、0%、30%、36%、94%,其基因同源性与标准菌株相比均大于90%。CagA+与VacA+存在正相关性。CagA+/VacAs1+/iceA2+的阳性率显著高于其他基因组合,单一基因及其不同组合在各组疾病中分布差异无统计学意义(P>0.05)。结论 CagA+/Va-cAs1+/iceA2+为贵州地区H.pylori的优势致病基因型,CagA、VacAs1、VacAm、iceA1、iceA2各单一基因及其他不同组合与临床结局的严重与否无关。Objective To explore the predominantly pathogenic genotypes of H. pylori in Guizhou Province and their association with clinical outcomes. Methods 50 clinical H. pylori strains were selected from 178 dyspeptic patients （28 strains from chronic no- atrophy gastritis patients,and 22 strains from peptic ulcer patients）. Expressions of CagA.VacAsl .VacAm.iceA1 and iceA2 were examined by Polymerase Chain Reaction （PCR）. The PCR amplified fragment was detected by gel electrophoresis and sequenced. BLAST was used to analyze the difference between clinical and standard strains. Chi-square test and Fisher exact test were used to analyze the correlation of the genotypes with clinical outcomes. Results The overall prevalence rates of CagA, VacAsl, VacAs2, VaeAm, iceA1, and iceA2 were 92%、94%、0%、30%、36%, and 94%, respectively. The presence of VacA was associated with the presence of CagA. Prevalence of CagA＋/VacAsl＋/iceA2＋ was significantly higher than other combination of genes in all patients. The presence of single genes and their different combinations was not associated with clinical outcomes. Conclusion CagA＋/ Va- cAsl ＋/iceA2 ＋ of H. pylori is the dominant pathogenic genotype in the Guizhou population. Individual genes of CagA,iceAl,iceA2, VacAm,VacAsl or their combinations may not influence the clinical outcomes.

关 键 词：螺杆菌 幽门 CAGA VACA ICEA 贵州 

分 类 号：R57[医药卫生—消化系统]