浙江人群幽门螺杆菌cagA/vacA优势基因型和不同基因型混合感染的调查

陈学军; 严杰; 毛亚飞; 李立伟

Abstract

陈学军,严杰,毛亚飞,李立伟.浙江人群幽门螺杆菌cagA/vacA优势基因型和不同基因型混合感染的调查[J].Chinese journal of Epidemiology,2003,24(11):1031-1035

浙江人群幽门螺杆菌cagA/vacA优势基因型和不同基因型混合感染的调查

Investigation on cagA/vacA dominant genotypes and the coinfection of Helicobacter pylori isolates from patients in Zhejiang

Received:September 09, 2002

DOI：

KeyWord: 螺杆菌,幽门 cag AvacA基因胃十二指肠疾病聚合酶链反应

English Key Word: Helicobacter pylori cagA/vacA gene Gastroduodenal diseases Polymerase chain reaction

FundProject:

Author Name	Affiliation
CHEN Xue-jun	Department of Pathogen Biology, College of Medical Sciences of Zhejiang University, Hangzhou 3100 31, China
YAN Jie	Department of Pathogen Biology, College of Medical Sciences of Zhejiang University, Hangzhou 3100 31, China
MAO Ya-fei	Department of Pathogen Biology, College of Medical Sciences of Zhejiang University, Hangzhou 3100 31, China
LI Li-wei	Department of Pathogen Biology, College of Medical Sciences of Zhejiang University, Hangzhou 3100 31, China

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Abstract:

目的了解消化性溃疡和慢性胃炎患者感染的幽门螺杆菌(Hp)cagA/vacA优势基因型及不同基因型Hp感染、混合感染与疾病的关系.方法选择胃窦、胃体双份活检标本均培养出Hp的42例慢性胃炎(CG)和36例消化性溃疡(PU)患者作为研究对象,采用聚合酶链反应(PCR)检测156份Hp分离株的cagA基因、vacA基因的信号区(s)和中间区(m)亚型,分析Hp基因型及多株Hp混合感染在CG和PU中的分布.结果胃窦标本cagA基因的检测中78例患者中有75例(96.2%)为cagA阳性,相应的胃体标本中,76例患者(97.4%)为cagA阳性,有1例(1.3%)患者胃窦、胃体检出cagA状态不一的Hp混合菌株.在胃窦标本的vacA基因分型中,s1a/m1、s1a/m2、s1a/m1b、s1a/m1b-m2 4种vacA基因型在78例患者中所占比例分别为6.4%(5/78)、55.1%(43/78)、26.9%(21/78)和1.3%(1/78),多株混合感染为3.8%(3/78);而相应的胃体标本中,前述四种vacA基因型所占比例依次为6.4%(5/78)、53.8%(42/78)、25.6%(20/78)和3.8%(3/78),多株混合感染为5.1%(4/78).cagA+ s1a/m2和cagA+ s1a/m1b在胃窦标本中占51.3%(40/78)和26.9%(21/78),而在相应的胃体标本中占52.6%(41/78)和25.6%(20/78).少量胃窦、胃体标本中vacA基因s区和m区不能分型,未发现s1b、s2和m1a型.联合胃窦、胃体标本分析,16例(20.5%)患者中检出不同基因型的多株Hp菌株,同一胃内多部位采样比单部位采样者有更高的混合感染检出率.Hp cagA基因、vacA基因型、cagA/vacA基因组合及不同基因型菌株混合感染在CG和PU中的分布差异均无显著性(P＞0.05).结论 cagA+ s1a/m2是浙江地区慢性胃炎或消化性溃疡中最主要的Hp菌株的优势基因型,其次为cagA+ s1a/m1b,部分患者同时感染不同基因型的多株Hp,但均与所致疾病类型和严重程度无密切相关.

English Abstract:

Objective To determine cagAvacA dominanTgenotypes of Helicobacter pylori in patients suffing from chronic gastritis ( CG) orpeptic ulcer ( PU), and to understand the correlation of differenTgenotype H. pylori infection, coinfection and the gastroduodenal diseases. Methods H. pylori strains were isolated from antrum and corpus samples on 42 patients with CG and 36 patients with PU. Polymerase chain reaction was used to detecTcagA and the s and m regions of vacA in 156 H. pylori isolates from both antrum and corpus. The distribution of H. pylori genotypes and coinfection in CG and PU was analyzed. ResultsAlmosTall of the isolated H. pylori strains were cagA positive. In region of vacA, only one genotype of signalregion (s1a) and four genotypesof the middle region ( m1, m2, m1b and m1b-m2) were found. The proportions of s1a m1, s1a m2, s1a m1b, s1a m1b-m2 and coinfection of multiple H. pylori strains in 78 isolates from antrum samples were 6. 4%, 55. 1%, 26. 9%, 1. 3% and 3. 8%; and the related proportions of those from corpus samples were 6. 4%, 53. 8%, 25. 6%, 3. 8% and 5. 1%, respectively. Sixteen ( 20. 5%) patients had multiple H. pylori strains with differenTcagA and vacA genotypes, and multiple samples were better than single sample taken from one stomach to increase the positive proportion of coinfection. ConclusioncagA+s1a m2 was the dominanTgenotype of H. pylori in the CG or PU patients followed by cagA+s1a m1b in the Zhejiang area of China. Some of the patients were coinfected with multiple H. pylori strains of differenTcagA and vacA genotypes. However, there was no significienTcorrelation between the genotypes or mixed infection with multiple strains, CG or PU.

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