幽门螺杆菌的毒力基因、vacA基因亚型与上消化道疾病关系的研究

Relationship among Toxicity Gene Type,vacA Gene Subtypes of Hp and Hp-related Upper Gastrointestinal Diseases

目的研究镇海地区幽门螺杆菌(Hp)尿素酶基因(ureA)、细胞毒素相关基因(cagA)、空泡细胞毒素基因(vacA)及vacA基因亚型与上消化道疾病之间的关系。方法用普通聚合酶链反应(PCR)技术,测定84株从上消化道疾病患者胃窦黏膜中分离获得的Hp的ureA基因、cagA基因、vacA基因、vacA基因亚型。结果84株Hp中,ureA、cagA、vacA基因的阳性率分别为100.00%、90.48%、95.24%,cagA、vacA在胃炎、消化性溃疡的阳性率高于胃癌(P<0.05);vacAm2基因的阳性率为79.76%,明显高于vacAm1a(20.24%)、vacAm1b(8.33%)及vacAm1bm2(4.76%),vacAm2在胃炎、消化性溃疡的阳性率高于胃癌(P<0.05),其余3个基因亚型阳性率差异均无统计学意义(均P>0.05)。结论镇海地区Hp相关性上消化道疾病患者感染Hp以ureA阳性、cagA阳性、vacAm2亚型占优势,且均在消化性溃疡及胃炎中的检出率更高。

OBJECTIVE To assess the relationship among the genes types ureA,cagA,vacA,gene vacA subtypes and Helicobacter pylori（Hp）-related upper gastrointestinal diseases in this study.METHODS Eighty-four Hp strains were identified from bacteria isolated and cultured from the gastric mucosa tissue.Genes ureA,cagA,vacA,and gene vacA subtypes were typed using PCR with specific primers.RESULTS In 84 identified Hp strains,the positive ratio of gene ureA was 100.00%,of gene cagA was 90.48%,and of gene vacA was 95.24%.The positive ratio of genes cagA and vacA was lower in gastric cancer than in gastritis and peptic ulcer（P〈0.05）,the positive ratio of vacAm2 was 79.76%,significantly higher than vacAm1a（20.24%）,vacAm1b（8.33%） and vacAm1bm2（4.76%）.The positive ratio of vacAm2 was significantly lower in gastric cancer,and with significant difference in gastritis and peptic ulcer（P〈0.05）,the other three subtypes were not significantly different in the gastric diseases（P〉0.05）.CONCLUSIONS ure＋,cagA＋ and vacAm2 subtypes of Hp are predominant in patients with upper gastrointestinal diseases in Zhenhai District,Ningbo,Zhejiang Province.They are more common in patients with gastric ulcer and gastritis.