摘要
目的分析浙江省台州地区幽门螺杆菌(helicobacter pylori,Hp)cag A和Vac A为主的毒力基因型分布,探讨其与克拉霉素耐药基因突变类型的关系。方法招募存在上消化道症状患者,并行胃镜检查活检患者胃黏膜组织。通过Hp分离培养方法,培养出216株Hp。采用聚合酶链式反应(polymerase chain reaction,PCR)检测并分析cag A和Vac A的分型情况。采用PCR扩增和Sanger测序技术检测克拉霉素耐药基因(23S rRNA)2142和2143位碱基点突变情况。结果 Cag A基因的阳性检出率为99.54%(215/216),其中Cag A-D为95.83%(207/216)、Cag A-C为3.70%(8/216)。Vac A基因阳性检出率为97.22%(210/216),s1、s2、m1、m2亚型分别为97.22%(210/216)、0、35.19%(76/216)、60.65%(131/216)。本研究发现,浙江省台州地区毒力基因以Cag A-D和Vac As1m2型为优势基因型。此外,23S rRNA基因2142和2143位点均未突变的有93株。突变的有123株,其中A2142G位点突变4株、A2143G位点突变119株。毒力基因型与23S rRNA基因2142和2143位点突变类型无相关性(P>0.05)。结论台州地区为HP高毒力地区,且以Cag A-D和Vac As1m2型为主,其分布与克拉霉素耐药基因突变无密切相关性。
Objective To analyze the distributions of virulence genes cag A and Vac A from helicobacter pylori（ Hp） and to study the relationship between virulence genotype and gene mutation associated with clarithromycin resistance. Methods A total of 216 Hp were isolated from gastric mucosal tissue in patients with upper gastrointestinal symptoms. The cag A and Vac A genotypes were detected and analyzed by polymerase chain reaction（ PCR）. The mutations at positions 2142 and 2143 of clarithromycin resistance gene（ 23 S rRNA）were detected by PCR and Sanger sequencing. Results The positive rate of Cag A gene was 99. 54%（ 215/216）,of which Cag A-D was95. 83%（ 207/216） and Cag A-C was 3. 70%（ 8/216）. The positive rate of Vac A gene was 97. 22%（ 210/216）,and the s1,s2,m1,and m2 subtypes were 97. 22%（ 210/216）,0,35. 19%（ 76/216） and 60. 65%（ 131/216）,respectively. In this study,Cag A-D and Vac As1 m2 were dominant genotypes in Taizhou region. Additionally,there were 93 Hp strians which were not mutated in 2142 and2143 gene loci of 23 S rRNA. There were 123 Hp mutants,of which 4 strains were A2142 G mutations and 119 strains were A2143 G mutations. There were no relationship between virulence genotype and 2142 and 2143 gene loci of 23 S rRNA mutation types（ P〈0.05）. Conclusion Taizhou is a region with high Hp toxicity and is mainly in Cag A-D and Vac As1 m2. The distribution of the Hp toxicity is not closely related to the clarithromycin-resistance gene mutation.
作者
章月桃
陈伟燕
朱临江
刘云惠
孟飞
Zhang Yu-etao;Chen Weiyan;Zhu Linjiang(Taizhou Central Hospital,Zhejiang 318000,China)
出处
《医学研究杂志》
2018年第6期82-84,143,共4页
Journal of Medical Research
基金
浙江省医药卫生科技计划项目(2018KY908)
浙江省科技厅公益技术应用研究项目(2016C33232
2017C33192)
关键词
幽门螺杆菌
毒力基因
克拉霉素耐药基因
Helicobacter pylori
Virulence genes
Clarithromyein resistance gene
