镇江地区胃肠病患者幽门螺杆菌vacA基因i、d区分型特点及临床关联  

Characteristics and clinical relevance of Helicobacter pylori vacA i、d alleles in Zhenjiang patients with gastrointestinal disease

作　　者：蒋双红[1] 吴莺[1] 贺明洁[1] 余小燕[1] 王静[1] 蒋晓猛[1] 周红[2] 

机构地区：[1]江苏大学附属医院消化科,江苏镇江212001 [2]江苏大学基础医学与医学技术学院,江苏镇江212013

出　　处：《江苏大学学报（医学版）》2013年第2期156-160,164,共6页Journal of Jiangsu University：Medicine Edition

基　　金：江苏省自然科学基金资助项目(BK2010336);江苏省研究生培养创新计划资助项目(1221270009)

摘　　要：目的:研究镇江地区胃肠病患者感染的幽门螺杆菌(Helicobacter pylori,H.pylori)的主要毒力因子vacA基因i、d型的分布特点、cagA基因状态,以及与临床结果的相关性。方法:选取快速尿素酶试验和(或)组织学染色H.pylori阳性患者的胃窦活检黏膜,PCR法检测H.pylori cagA基因状态、vacA基因的s、m、i、d区分型。结果:179例H.pylori患者,2例为混合感染(1.1%,2/179),剔除后,i1、i2亚型分别为96.6%(171/177)、1.1%(2/177);d1、d2亚型分别为98.9%(175/177)、1.1%(2/177);cagA阳性率为97.7%(173/177);s1/m2/i1/d1型为优势基因型(56.5%,100/177),s1/m1/i1/d1型次之(38.4%,68/177)。s2/m2型与i2、d2型相关(P<0.05),s1、i1、s1/i1型及cagA阳性均与d1型相关(P均<0.05)。比较vacA基因的s、m、i、d分型及cagA基因状态在慢性胃炎、消化性溃疡、胃癌中的分布,差异无统计学意义(P均>0.05)。结论:镇江胃肠病患者感染的H.pylori菌株,96.6%表现为i1亚型、98.9%为d1亚型,vacA s1/m2/i1/d1/cagA(+)为优势基因型;幽门螺杆菌基因型之间存在关联;vacA基因型、cagA基因状态与胃肠疾病的分布无相关性。Objective： To study the characteristics and clinical relevance of Helicobacter pylori（H.pylori） two major virulence markers： the vacuolation toxin（vacA） i、d alleles and the cytotoxin-associated gene product（cagA） status in Zhenjiang patients with gastrointestinal disease.Methods： Rapid urease test and/or histology was performed to diagnose the gastric antrum mucosa of H.pylori infection.The vacA s-,m-,i-and d-region genotypes and cagA status were investigated by polymerase chain reaction（PCR）.Results： In 179 H.pylori cases,2 was mixed infections（1.1%,2/179）.The genotypes of vacA were found： i1（96.6%,171/177）,i2（1.1%,2/177） and d1（98.9%,175/177）,d2（1.1%,2/177）;The positive rates of cagA gene was 97.7%（173/177）,the major recombination was s1/m2/i1/d1（56.5%）,followed by s1/m1/i1/d1（38.4%）.VacA s2/m2 was associated with i2,d2（P＆lt;0.05）.s1,i1,s1/i1 and cagA positive status was associated with d1（both P＆lt;0.05）.The distribution of s,m,i,d alleles and cagA status showed no significant difference among chronic gastritis,peptic ulcer and gastric cancer（both P＆gt;0.05）.Conclusion： s1/m2/i1/d1/cagA（＋） of H.pylori was the major recombination in Zhenjiang patients with gastrointestinal disease.There was a correlation among H.pylori genotypes.There was no association between vacA genotypes,cagA status and the distribution of gastrointestinal diseases.

关 键 词：幽门螺杆菌 vacA等位基因 CAGA基因 胃肠疾病 

分 类 号：R378.99[医药卫生—病原生物学]