摘要
目的:了解广西地区上消化道疾病患者幽门螺杆菌(H pylori)细胞毒素相关蛋白(CagA)基因的表达情况及其对常用抗生素的敏感性,为临床诊疗H pylori感染提供理论依据.方法:从上消化道疾病患者胃黏膜中分离出50株H pylori,用特异性引物扩增H pylori CagA基因到297bp片段,经聚合酶链反应(PCR)检测,同时采用E-test法对这50株H pylori进行抗生素敏感试验.结果:50株H pylori中有76%(38/50)的菌株有CagA基因,其表达在消化性溃疡患者与慢性胃炎患者以及男性与女性患者间差异无显著性.50株Hpylori对甲硝唑的耐药率为86.0%(43/50),克拉霉素的耐药率为6.0%(3/50),四环素的耐药率为4.0%(2/50),未发现对阿莫西林耐药的菌株.甲硝唑的耐药率明显高于四环素和克拉霉素的耐药性(P<0.01)CagA阳性菌株耐药性为89.5%(34/38),CagA阴性菌株的耐药率为75.0%(9/12),两者比较差异无显著性.结论:广西地区CagA阳性菌株是上消化道疾病发生的主要因素.H pylori对阿莫西林、克拉霉素和四环素的敏感性较高,可作为抗H pylori的首选药物,甲硝唑的耐药率高,临床上治疗H
AIM： To determine the expression of CagA gene of Helicobacter pylori （H pylori） strains and its resistance to common drugs in Guangxi Zhuang Autonomous Region, and thereby to provide a theoretical basis for clinical diagnosis and treatment. METHODS： Fifty H pylori strains were isolated and CagA gene of H pylori was amplifi ed using specif ic primers into 297 bp. H pylori was determined using PCR for CagA gene and E-test was performed to estimate H pylori＇s susceptibility. RESULTS： The expression of CagA in H pylori strains was 76.0% （38/50）. There were no significant CagA gene expressional differences between peptic ulcer and chronic gastritis or between female and male. Resistance rates of H pylori strains were as follows： 86.0% （43/50）to metronidazole, 6.0% （3/50） to clarithromycin and 4.0%（2/50） to tetracycline. There were no H pylori strains resistant to amoxicilin. Resistance to metronidazole was significantly higher than that to other drugs （P 〈 0.01）. The percentage of CagA-positive resistant strains was 89.5% （34/38） and that of CagA-negative resistant strains was 75% （9/12）. There was no significant difference between CagA-negative and CagA-positive strains. CONCLUSION： CagA-positive H pylori strains are mainly responsible for gastroenteric diseases. In Guangxi Zhuang Autonomous Region, high susceptibility of H pylori to amoxiciline, clarithromycin and tetracycline indicate that they are drugs of first choice for H pylori eradication therapy. However, as resistance to metronidazole is high, metronidazole should be avoided where possible.
出处
《世界华人消化杂志》
CAS
北大核心
2008年第18期2072-2075,共4页
World Chinese Journal of Digestology
