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目的对慢性胃炎患者胃黏膜菌群进行定位及定量分析,探究其与胃炎及幽门螺杆菌(Helicobacter pylori,H.pylori)感染的相关性。方法收集58例慢性胃炎患者胃黏膜标本,提取胃黏膜菌群DNA,行荧光定量PCR定量胃黏膜总细菌及H.pylori,并进行相关性分析;另收集12例慢性胃炎患者胃黏膜标本石蜡包埋切片行荧光原位杂交定位胃黏膜菌群;慢性胃炎、肠化生程度的分类依据新悉尼分类系统。结果慢性胃炎患者胃黏膜细菌主要分布于胃黏膜表面、胃小凹及腺体中,细菌单个散在分布或聚集成团。多元线性回归分析显示胃黏膜总细菌数与性别、年龄、肠化生程度无关,与H.pylori感染、慢性胃炎程度有关(P<0.05)。H.pylori阳性组胃黏膜总细菌数与H.pylori细菌数目呈明显正相关(r=0.536,P<0.01)。不同胃炎程度之间胃黏膜总细菌数差异有统计学意义(P<0.05),其中重度胃炎组胃黏膜总细菌数明显高于轻、中度胃炎组(P<0.05、0.01)。不同肠化生程度之间胃黏膜总细菌数差异无统计学意义(P>0.05)。H.pylori阳性组胃黏膜总细菌数明显高于阴性组(P<0.01)。结论慢性胃炎患者胃黏膜菌群主要分布于胃黏膜表面、胃小凹及腺体中,细菌单个散在分布或聚集成团。胃黏膜菌群与慢性胃炎程度、H.pylori感染有关,与性别、年龄、肠化生程度无关,提示胃黏膜菌群的改变参与慢性胃炎的发展,H.pylori感染可改变胃黏膜菌群。
Objective To investigate the localization and quantitative analysis of gastric mucosal flora in patients with chronic gastritis and to explore the relationship between them and gastritis and Helicobacter pylori (H.pylori) infection. Methods Fifty-eight gastric mucosa specimens from patients with chronic gastritis were collected, DNA of gastric mucosa was collected, total bacteria and H.pylori in gastric mucosa were quantified by fluorescence quantitative PCR, and correlation analysis was performed. In addition, 12 gastric mucosa specimens from patients with chronic gastritis Gastric mucosa colonies were localized by fluorescence in situ hybridization. The classification of chronic gastritis and intestinal metaplasia was based on the New Sydney classification system. Results Gastric mucosal bacteria in patients with chronic gastritis were mainly distributed in the gastric mucosa surface, gastric pits and glands. Bacteria were scattered or clustered into clusters. Multivariate linear regression analysis showed that the total number of bacteria in gastric mucosa was not related to the gender, age and intestinal metaplasia, but also to the degree of H.pylori infection and chronic gastritis (P <0.05). The total number of gastric mucosa in H.pylori positive group was positively correlated with the number of H.pylori bacteria (r = 0.536, P <0.01). There were significant differences in the total number of bacteria in gastric mucosa between different degrees of gastritis (P <0.05). The total number of bacteria in severe gastritis group was significantly higher than those in mild to moderate gastritis group (P <0.05, 0.01). There was no significant difference in the total number of bacteria in gastric mucosa between different intestinal metaplasia (P> 0.05). The total number of gastric mucosa in H.pylori positive group was significantly higher than that in the negative group (P <0.01). Conclusion The gastric mucosal flora in patients with chronic gastritis is mainly distributed in the surface of gastric mucosa, gastric pits and glands, and the bacteria are scattered or aggregated into clusters. Gastric mucosal flora and chronic gastritis, H.pylori infection, sex, age, intestinal metaplasia had nothing to do, suggesting that gastric mucosal changes involved in the development of chronic gastritis, H.pylori infection can change the gastric mucosal flora.