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目的 研究上海地区儿童慢性胃炎及消化性溃疡患者中具有cagA、vacA基因幽门螺杆菌感染 (HP)的感染状况以及cagA、vacA基因的存在与不同种类胃十二指肠疾病发生的关系。方法 对 12 4例有消化道症状 ,年龄在 4～ 13岁的儿童行胃镜检查 ,并在胃窦部取活检粘膜作HP的分离培养。利用聚合酶链反应技术 (PCR)测定分离培养出的HP菌株的cagA、vacA基因进行分型。扩增所用引物 :cagA1:5′ CCGGAGAATTCGATAACAGGCAAGCTTTTGAGG 3′ ,cagA2 :5′ GCCTGCAGTTATCGAAAA GATTGTTTGGCAG 3′,vacA1:5′ GTCAGCATCACACCGCAAC 3′ ,vacA2 :5′ CTGCTTGAATGCGCCAAAC 3′。结果 12 4例患儿中 ,分离培养出的HP菌株 6 1株 ,平均检出率为 5 0 0 % ,其中慢性胃炎培养阳性率为 48 45 % (4 7/ 97例 ) ,十二指肠球部溃疡为 6 2 30 % (14/ 2 6例 ) ,基因测定结果显示 ,6 1株HP中6 2 30 %含有cagA基因 ,42 6 2 %含有vacA基因。慢性胃炎和十二指肠球部溃疡cagA基因检出率相似(分别为 6 1 70 %和 6 4 2 8% ) ,而vacA基因检出率十二指肠球部溃疡明显高于慢性胃炎组 (71 43%和34 0 4% ,χ2 =6 16 6 ,P <0 0 5 )。进一步分型发现感染Hp菌株的十二指肠球部溃疡患儿中 ,5 0 % (7/14)为cagA+ 、vacA+ 型 ,慢性胃炎患儿中 38 30 % (18/
Objective To investigate the prevalence of cagA and vacA gene Helicobacter pylori (HP) infection in children with chronic gastritis and peptic ulcer in Shanghai and the relationship between the presence of cagA and vacA gene and different types of gastroduodenal diseases. Methods Gastroscopy was performed in 124 children with gastrointestinal symptoms, aged from 4 to 13 years old, and biopsy mucosa was taken from the gastric antrum for HP isolation and culture. The cagA and vacA genes of isolated and cultured HP strains were determined by polymerase chain reaction (PCR). The primers used were: cagA1: 5 ’CCGGAGAATTCGATAACAGGCAAGCTTTTGAGG 3’, cagA2: 5 ’GCCTGCAGTTATCGAAAA GATTGTTTGGCAG 3’, vacAl: 5 ’GTCAGCATCACACCGCAAC 3’, vacA2: 5 ’CTGCTTGAATGCGCCAAAC 3’. Results Among 12 4 cases, 6 strains of HP strains were isolated and cultured, with an average detection rate of 500%. The positive rate of chronic gastritis culture was 48 45% (47/97), duodenal The ulceration of the ulna was 6230% (14/2 6 cases). The results of gene assay showed that 6230% of 6 1 strains contained cagA gene and 4262% contained vacA gene. Chronic gastritis and duodenal ulcer cagA gene detection rates were similar (6 1 70% and 6 4 2 8%), while vacA gene detection rate of duodenal ulcer was significantly higher than the chronic gastritis group (71 43% vs 34 0 4%, χ 2 = 6 16 6, P 0 05). Further genotyping found that 50% (7/14) of the children with duodenal ulcer infected with Hp were cagA +, vacA + type, 38.3% (18 /