幽门螺杆菌感染及其毒力相关基因cagA的分布与临床胃疾患关系探讨

Study on Relationship between Infection of Helicobacter pylori,cagA-Hp,and Gastric Diseases

目的探讨幽门螺杆菌感染及其毒力相关基因cagA的分布及与临床胃部疾患严重程度的关系。方法取306例有上消化道症状患者的胃粘膜病变组织并确定H.pylori感染;用PCR方法对H.pylori-cagA基因进行检测,并对cagA进行序列分析。结果①共分离培养H.pylori临床菌株148株,其中来自慢性胃炎38株,消化性溃疡36株,萎缩性胃炎48株,胃癌26株;②148株H.pylori临床分离株中cagA阳性菌株140株。结论本地区临床胃疾患病人中H.pylori的检出率为48.36%(148/306),cagA的阳性率为94.59%(140/148),cagA基因与标准菌株cagA序列相比对有一定的差异。cagA在各个类型的胃部疾病中的检出率都比较高,提示cagA的存在与H.pylori感染有关,但是与临床感染疾病类型无关。

Objective To investigate the correlation between Helicobacter pylori （H.pylori） infection, cagA positive rate, and the severity of the gastric diseases. Method Gastric biopsy specimens were obtained from 306 patients. H.pylori was identified by culturing method, cagA gene was determined by PCR, and the sequence was analyzed. Result （1）148 H.pylori isolates were obtained in patients with gastric disease from Lvliang area, in which 38 isolates were obtained from patients with chronic stomach inflammation. 36 isolates were obtained from patients with peptic ulcer, 48 isolates from patients with atrophy gastritis, and 26 isolates from patients with gastric cancer. （2）Of the 148 clinical isolates, 140 were positive for cagA. Conclusion The positive identification rate of H.pylori was 48.36% （148/306）. The positive rate of cagA was 94.59% （140/148）. The sequence of cagA in these isolates were different from the standard strain. Although the detection of cagA is highly correlated with the H.pylori infection, the positive detection of cagA is not correlated with the type of disease.