嘉兴地区幽门螺杆菌临床菌株cagA和vacA优势基因型研究

目的研究嘉兴地区幽门螺杆菌（Hdicobacter pylori，Hp）临床菌株cagA和vacA优势基因型状况及与疾病的关系。方法从胃、十二指肠疾病患者的胃粘膜活检组织中分离培养出44株HD。采用PCR检测cagA基因和vacA基因的信号区（s）和中间区（m）亚型的分布，用卡方检验分析各基因在不同消化性溃疡或慢性胃炎中的Hp差异。结果44株Hp中cagA的阳性率为100％（44／44），vacA sla／m2基因型阳性率为61．4％（27／44），vacA sla／mlb为25．0％（11／44），vaeA sla／mlb-m2为9．0％（4／44），其中有2株HD同时检出sla／m2和sh／mlb-m2基因，另有2株Hp未检测到m区基因。慢性胃炎患者Hp的vacA sla／m2和vacA sla／mlb基因阳性率赐显高于消化性溃疡患者的Hp（P〈0．05），其余基因在不同类型疾病中的分布无统计学差异（P〉0．05）。结论cagA＋vacA sla／m2、cagA＋vacA sla／mlb均为嘉兴地区消化性溃疡或慢性胃炎患者感染的Hp的优势基因型，部分患者可混合感染多株不同vacA基因型的HD。

Study on the CagA and VacA Genotypes of Helicobactor Pylori in Jiaxing Area

Objective To explore the distribution of CagA and VacA genotypes of helicobactor pylori in patients with peptic ulcer （PU） and gastritis （CG） and to understand the relationship between CagA or VacA genotypes and the diseases. Methods 44 strains Helicobactor pylori were isolated from the gastric mucosa biopsy tissues of the patients with gastroduodenal diseases. Polymerase chain reaction （PCR） was used to detect CagA and the s and m regions of VacA. The distribution of Helicobuctor pylori genotypes was analyzed in the patients with peptic ulcer or gastritis by x^2 test. Results All of the 44 strains Heliccbactor pylori were CagA positive （100%）. The positive rates of VacA sla/m2, VacA sla/mlb and VaeA sla/ mlb-m2 were 61.4%, 25.0% and 4.5%, respectively. 2 strains Helicobactor pylori both had CacA sla/m2 and VacA sla/ mlb-m2. And 2 other strains Heliccbactor pyhiri were found out of the known types of m region in VacA. The positive rates of VacA sla/m2 and VacA sla/mlb were significantly higher in the patients with gastritis than with peptic ulcer （P 〈 0.05） . There were no statistical differences of other genotypes among different diseases （P 〉 0.05 ）. Conclusion CagA ＋ VacA sla/ m2 and CagA ＋ VacA sla/mlb of Helicobactor pylori are the dominant genotypes in the patients with PU or CG in Jiaxing area. Different VacA genotypes of Helieebactor pylori may simultaneonsly exist in some patients.