消化不良患者口腔和胃黏膜白色念珠菌多位点序列分型状况  

Multilocus sequence typing of Candida albicans isolates from oral and gastric mucosa of dyspeptic patients

作　　者：齐贺[1] 宫雁冰[2] 黄竹青[1] 刘颖[1] 郑剑玲[1] 张秀英[3] 车颖[2] 赵同香[2] 张蓉[4] 

机构地区：[1]辽宁省基础医学研究所免疫研究室,辽宁省沈阳市110101 [2]北京大学首钢医院科研处,北京市100144 [3]北京大学首钢医院病案室,北京市100144 [4]北京大学首钢医院口腔内科,北京市100144

出　　处：《世界华人消化杂志》2015年第34期5443-5451,共9页World Chinese Journal of Digestology

基　　金：辽宁省教育厅科学技术研究基金资助项目;No.L2012499;辽宁省科技厅自然科学基金资助项目;No.201202102~~

摘　　要：目的:本研究通过检测消化不良患者胃黏膜白色念珠菌多位点序列分型(multilocus sequence typing,MLST)状况,探寻是否有胃黏膜炎症损伤密切相关的白色念珠菌基因型,为研究胃黏膜炎症损伤的提供微生物学基础.方法:用胃镜钳取胃炎、胃溃疡患者的病损区胃黏膜标本102例,并采集口腔黏膜拭子样本111例,为患者组.采集健康志愿者口腔黏膜拭子样本162例,为正常对照组.样本用念珠菌显示培养基进行分离培养,初步菌种鉴定.分离培养的念珠菌菌株样本提取DNA,ITS1-5.8S-ITS2序列检测,进一步菌种鉴定.将白色念珠菌菌株样本进行MLST检测,并向MLST数据库申报ST序列号,用UPGMA法构建进化树,分析进化分支方向与胃黏膜炎症损伤的关系.结果:对照组和患者组的口腔黏膜拭子样本,念珠菌阳性率分别为29.6%和36.0%,白色念珠菌构成比分别为64.6%和95.0%.患者组的胃黏膜样本中,念珠菌阳性率为41.4%,白色念珠菌构成比为97.8%.患者组的念珠菌阳性率及白色念珠菌构成比均高于正常对照组(c2=4.071,P<0.01;c2=7.650,P=0.006).白色念珠菌MLST检测,ST1593基因型在患者组中检出率高于对照组(60.0%vs 14.8%;c2=12.815,P<0.001);菌株所在的不同进化分支与胃黏膜炎症损伤关系密切(Kendall's tau-br=0.591,P<0.001).结论:在消化不良患者中,可以检出与胃黏膜炎症损伤密切相关的白色念珠菌基因型.AIM：To detect the genetic profiles of Candida albicans（C.albicans） strains in the digestive tract of dyspeptic patients by multilocus sequence typing（MLST）,and to explore whether lesion of the gastric mucosa is closely related to the genotype of C.albicans.METHODS：A total of 111 oral swab samples and 102 gastric mucosa samples were collected from patients with gastritis or gastric ulcer.In addition,162 oral swab samples collected from healthy volunteers were used as a control group.Candida species isolates from separate samples were identified by amplifying the ITS1-5.8S-ITS2 region sequence.C.albicans isolates were characterized and analyzed by multilocus sequence typing,and submitted to the C.albicans MLST database.The phylogenetic tree was constructed by the method of unweightedpair group method using average linkages（UPGMA） to analyze the relationship between the evolutionary clades and gastric mucosal inflammation lesion.RESULTS：In the oral mucosa swab samples of the control group and patient group,the positive rates of Candida spp.were 29.6%vs36.0%,and the constitute ratios of C.albicans were 64.6%vs 95%,respectively.In the gastric samples of the patient group,the positive rate of Candida spp.was 41.4%,and the constituent ratio of C.albicans was 97.8%.Both the positive rate and constituent ratio of C.albicans in the patient group were significantly higher than those in the control group（x2 = 4.071,P〈0.01;x2 = 7.650,P = 0.006）.In C.albicans MLST detection,the positive rate of genotype ST1593 was significantly higher in the patient group than in the control group（60%vs 14.8%;x2 =12.815,P〈0.001）.The different evolutionary clades of C.albicans strains were closely related to the inflammatory lesion of the gastric mucosa（Kendall＇s tau-b r = 0.591,P〈0.001）.CONCLUSION：C.albicans could be detected in the gastric mucosa of patients with dyspepsia,and its special genotype is closely related to the inflammatory lesion of the gastric mucosa.

关 键 词：消化不良 胃炎 胃溃疡 白色念珠菌 多位点序列分型 

分 类 号：R57[医药卫生—消化系统]