幽门螺杆菌毒力基因与临床相关性的分析  

Correlation of Helicobacter pylori virulence genotypes and clinical characteristics

作　　者：胡玢婕 赵付菊[1] 王诗雯[1] 项平[2] 杨长青[3] 方毅[1] 陈飞[1] 杨峰[1] 赵虎[1] 张艳梅[1] 

机构地区：[1]复旦大学附属华东医院检验科,上海200040 [2]复旦大学附属华东医院胃镜室,上海200040 [3]同济大学附属同济医院消化科,上海200065

出　　处：《检验医学》2016年第6期479-485,共7页Laboratory Medicine

基　　金：上海市科学技术委员会引导项目(14411962800);上海市科学技术委员会自然科学基金资助项目(14ZR1413100);上海市卫生和计划生育委员会重点课题(20134008);上海申康医院发展中心"市级医院新兴前沿技术联合攻关项目"(SHDC12013123)

摘　　要：目的了解上海地区幽门螺杆菌临床分离株毒力基因携带的分子特征,探究其基因型与临床幽门螺杆菌感染性胃十二指肠疾病的相关性。方法收集514例临床胃黏膜活检样本,分离培养幽门螺杆菌;设计和合成10对幽门螺杆菌毒力基因型的特异性引物,检测临床分离的幽门螺杆菌中携带的毒力基因,并分析其与幽门螺杆菌感染相关的临床疾病[慢性浅表性胃炎、慢性萎缩性胃炎和消化性溃疡(PUD)]的相关性。结果从514例胃黏膜活检样本中分离出幽门螺杆菌129株。幽门螺杆菌分离株携带多种毒力基因,包括cag A、vac A(m1、m2、s1)、ice A1、ice A2、dup A、lux S、oip A,其中vac A s1m2基因型与ice A1^+/ice A2^+混合基因型增加了PUD发生的危险程度,而vac A s1m1基因型则是慢性活动性胃炎的危险因素。dup A显著增加了十二指肠溃疡的危险度。结论上海地区幽门螺杆菌携带多种毒力基因,ice A1^+/ice A2^+和vac A s1m2基因型可能是PUD危险因子。dup A可考虑作为十二指肠溃疡的标记分子。Objective To study the molecular characteristics of Helicobacter pylori virulence genotypes and the correlation with different Helicobacter pylori-infected gastroduodenal diseases. Methods A total of 514 gastric mucosa biopsy samples were collected. Helicobacter pylori was isolated. Ten kinds of specific probes for Helicobacter pylori virulence genotypes were designed and synthesized,and the specific virulence genes were detected. The correlation of Helicobacter pylori virulence genotypes and clinical characteristics [chronic superficial gastritis,chronic atrophic gastritis and peptic ulcer disease(PUD)] was analyzed. Results A total of 129 isolates of Helicobacter pylori were isolated from 514 gastric mucosa biopsy samples. Helicobacter pylori carried multiple kinds of virulence genotypes,such as cag A,vac A(m1,m2 and s1),ice A1,ice A2,dup A,lux S and oip A. Genotype vac A s1m2 and the combined genotype ice A1^+/ice A2^+ had an increased risk for PUD. Genotype vac A s1m1 was a risk factor for chronic active gastritis,while dup A was closely associated with duodenal ulcer. Conclusions Helicobacter pylori isolated from Shanghai carrys many kinds of virulence genes,ice A1^+/ice A2^+ and vac A s1m2 maybe risk factors for PUD,and dup A could be considered as a duodenal ulcer-specific virulence marker.

关 键 词：幽门螺杆菌 毒力基因 胃十二指肠疾病 临床相关性 

分 类 号：R446.5[医药卫生—诊断学]