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胡素侠杨立新程龙强蔡霞张荣波.淮南地区幽门螺杆菌感染个体菌株基因多态性与感染结局的影响[J].,2014,14(18):3531-3535

淮南地区幽门螺杆菌感染个体菌株基因多态性与感染结局的影响

Gene Polymorphism of Individual Strains of Helicobacter pylori in Huainanand Infection Outcomes

DOI：

中文关键词: 幽门螺杆菌 cagA 基因 vacA 基因 iceA基因 babA2 基因感染结局

英文关键词: Helicobacter pylori CagA gene VacA gene IceA gene BabA2 gene Infection outcome

基金项目:淮南市科技计划项目（2012A01402）

作者	单位
胡素侠杨立新程龙强蔡霞张荣波	淮南市第一人民医院检验科淮南市第一人民医院耳鼻喉科安徽理工大学分子与免疫实验室

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中文摘要:

目的：探讨淮南地区幽门螺杆菌感染个体菌株基因多态性及其与感染结局的影响。方法：选取125 例幽门螺杆菌（ )感染的慢性胃炎、消化性溃疡患者，常规获取胃窦、胃体部粘膜，进行HP 分离、培养，提取HP 基因组DNA，采用随机扩增多态性DNA（RAPD）指纹分析法检测菌株基因多态性；125 例患者均给予质子泵抑制、H2 受体拮抗剂、铋剂为基础的三联或四联疗法治疗，治疗后4~6 周进行14C-尿素呼气试验评估Hp 根除情况；获取HP 根除失败患者的胃窦、胃体黏膜进行HP 分离、培养、鉴定，并采用RAPD 指纹分析法检测菌株来源，评估HP 基因多态性对治疗结局的影响。结果：cagA、iceA1、iceA2、vacAs1、 vacAm1、babA2 阳性率分别为92.80%、36.00%、93.60%、93.60%、29.50%、53.50%，cagA、iceA2、vacAs 阳性率均高于其他基因类型阳性率（P<0.05或P<0.01)，其他基因类型阳性率比较差异无统计学意义（P>0.05)。经治疗后HP根除率为86.4%(107/125)，14.4% （18/125)根除失败；18 例根除失败患者中，15例患者治疗前后的菌株具有相同的指纹图谱，证实为原菌株复发，其中cagA、iceA1、 iceA2、vacAs1、vacAm1、babA2 阳性率分别为93.33%、13.33%、86.67%、93.33%、6.67%、20.00%，cagA、iceA2、vacAs 阳性率均高于其他基因类型阳性率（P<0.05 或P<0.01)。结论：cagA+、vacAs+、iceA2+为淮南地区HP 感染的优势基因型，该基因型易导致HP 根除失败；未发现babA2与HP感染结局存在相关性。

英文摘要:

Objective:To investigate the gene polymorphism and infection outcome of individual strains of Helicobacter pylori infection in Huainan region.Methods:Helicobacter pylori was isolated from the gastric antrum, gastric mucosa of 125 patients with HP infected chronic gastritis or peptic ulcer and cultured. Then HP DNA was extracted. Random amplified normality DNA (RAPD) fingerprinting assay was used to test the strain polymorphism. Then the 125 patients were treated with proton pump inhibitors, H2 receptor antagonists, bismuth-based triple or quadruple therapy. After treatment for 4 to 6 weeks, 14C-urea breath test was used for Hp eradication assessment. Then the HP were isolated from gastric antrum, gastric mucosa of patients with HP eradication failure, cultured and identified, and analyzed by RAPD fingerprinting assay to assess the effects of HP genetic polymorphism on treatment outcome.Results:The positive rates of cagA, iceA1, iceA2, vacAs1, vacAm1 and babA2 were respectively 92.80%, 36.00%, 93.60%, 93.60%, 29.50%and 53.50%. The positive rates of cagA, iceA2, vacAs were significantly higher than other types of gene-positive rate (P<0.05 or P<0.01), and other types of gene positive rates had no significant difference (P>0.05). After treatment, 86.4% (107/125) had HP eradication, and 14.4% (18 / 125 ) failed. Among the18 patients with eradication failure, 15 had the same strain fingerprints before and after treatment, and were confirmed as the original strain recurrence. Their positive rates of cagA, iceA1, iceA2, vacAs1, vacAm1, babA2 were respectively 93.33%, 13.33%, 86.67%, 93.33%, 6.67%, 20.00%; the rates of cagA, iceA2, vacAs were significantly higher than other types of genes positive rate (P<0.05 or P<0.01).Conclusion:cagA +, vacAs +, iceA2 + were the dominant genotype of HP infection in Huainan region. These genotype easily lead to HP eradication failure. babA2 was found having no correlation with the presence of HP infection outcome.

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