儿童CYP2C19基因代谢型与幽门螺杆菌感染的相关性  

Correlation of CYP2C19 genotypes and Helicobacter pylori infection in children

作　　者：于飞鸿 郭景 何利华[3] 伏利兵 李东丹 崔晓双 徐樨巍 Yu Feihong;Guo Jing;He Li- hua;Fu Libing;Li Dongdan;Cui Xiaoshuang;Xu Xiwei(Department of Gastroenterology, National Center for Children＇s Health, China, Beijing Children＇s Hospital of Capital Medical University, National Clinical Research Center for Digestive Diseases, Faculty of Digestive Diseases, Capital Medical University, Beijing 100045, China;Department of Pathology, National Center for Children＇s Health, China, Beijing Children＇s Hospital of Capital Medical University, Beijing 100045, China;National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102205, China)

机构地区：[1]国家儿童医学中心首都医科大学附属北京儿童医院消化科首都医科大学消化病学系国家消化系统疾病临床医学研究中心,北京100045 [2]国家儿童医学中心首都医科大学附属北京儿童医院病理科首都医科大学消化病学系国家消化系统疾病临床医学研究中心,北京100045 [3]中国疾病预防控制中心传染病预防和控制研究所,北京102206

出　　处：《中华实用儿科临床杂志》2018年第7期496-500,共5页Chinese Journal of Applied Clinical Pediatrics

基　　金：国家科技支撑计划课题（2012BAI06B02）

摘　　要：目的探究幽门螺杆菌（Hp）感染儿童CYP2C19基因代谢型分布及其与性别、年龄、临床症状发作程度、频率评分及胃窦黏膜病理分级等方面的相关性。方法收集首都医科大学附属北京儿童医院2013年7月至2015年12月214例Hp感染患儿的胃窦黏膜，提取胃窦黏膜DNA，应用PCR-序列特异性引物分析方法进行CYP2C19基因代谢型检测，根据结果分为纯合子快代谢型（HomEM）、杂合子快代谢型/中间代谢型（HetEM）及弱代谢型（PM），并分别统计各组患儿在性别、年龄、临床症状发作程度及频率评分、胃窦黏膜病理分级等方面的差异性。结果1．Hp感染214例患儿中，HomEM占48.1%（103/214例），HetEM占46.3%（99/214例），PM占5.6%（12/214例）。Hp感染患儿PM CYP2C19基因代谢型显著低于中国汉族健康人群，差异有统计学意义（P〈0.05）。2.男124例，女90例；年龄2岁8个月～17岁11个月（中位数9岁9个月），CYP2C19基因代谢型在不同性别及年龄患儿间的分布差异无统计学意义（均P〉0.05）。3.CYP2C19基因代谢型在不同临床症状严重程度及发作频率总分的患儿间分布差异无统计学意义（均P〉0.05）。4.胃窦黏膜炎症病理分级HomEM组轻度14例，中度36例，重度53例；HetEM组轻度17例，中度29例，重度53例；PM组轻度2例，中度3例，重度7例。CYP2C19基因代谢型在不同胃窦黏膜病理炎症程度的患儿间分布差异无统计学意义（均P〉0.05）。5.未进行Hp根除治疗35例，Hp根除治疗失败1次者78例，根除治疗失败≥2次者101例，不同根除治疗次数的患儿胃窦黏膜病理炎症程度比较差异有统计学意义（χ2＝12.414，P〈0.05），并呈正相关（r＝0.219，P〈0.01）。结论Hp感染儿童CYP2C19基因代谢型分布与性别、年龄、临床症状及胃窦黏膜病理炎症程度无明显相关性。Hp感染根除治疗失败次数与胃窦黏膜病理炎症程度呈正相关。ObjectiveTo evaluate CYP2C19 genotypes distribution in children with Helicobacter pylori （Hp） infection and to know its correlation with gender, age, severity and frequency of clinical symptoms, pathological classification of gastric antral mucosa.MethodsAntral mucosas of 214 Hp infection patients who were hospitalized at Beijing Children′s Hospital of Capital Medical University from July 2013 to December 2015 were collected.Genotypes were determined by PCR-sequence specific primer method, which were classified as homozygous extensive metabolizer （HomEM）, heterozygous extensive metabolizer （HetEM） and poor metabolizer （PM）. The differences in CYP2C19 genotype distribution in gender, age, severity and frequency of clinical symptoms, pathological classification of gastric antral mucosa were analyzed.Results（1）Among 214 Hp infected children, the percentage of HomEM was 48.1%（103/214 cases）, HetEM was 46.3%（99/214 cases）, and PM was 5.6%（12/214 cases）. PM in the CYP2C19 infection patients was lower than that in the normal Han nationality in China, and the difference was statistically significant （P〈0.05）. （2）Among the 214 Hp infected patients, there were 124 males and 90 females, and their median age was 9 years and 9 months（ranged from 2 years and 8 months to 17 years and 11 months）. There was no statistical difference in gender and age of CYP2C19 genotypes（all P〉0.05）. （3）There was no statistical difference in severity and frequency of clinical symptoms of CYP2C19 genotypes（all P〉0.05）. （4）In HomEM group, according to pathological classification of gastric mucosa, there were 14 cases of mild injury, 36 cases of moderate injury and 53 cases of severe injury, respectively.In HetEM group, there were 17 cases of mild injury, 29 cases of moderate injury and 53 cases of severe injury, respectively.In PM group, there were 2 cases of mild injury, 3 cases of moderate injury and 7 cases of severe injury, respectively.There was no statistical difference in th

关 键 词：幽门螺杆菌 CYP2C19基因 儿童 

分 类 号：R725.7[医药卫生—儿科]