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目的调查分析沈阳和抚顺地区上消化道疾病患者胃黏膜念珠菌感染状况。方法胃镜下钳取沈阳和抚顺地区214例上消化道疾病患者胃黏膜,快速尿素酶法检测幽门螺杆菌(Helicobacter pylori,H.pylori);采用CHROMagar培养基显色培养念珠菌,对分离到的各病患组念珠菌菌株进行内转录间隔区(internal transcribed spacer region,ITS)测序并申请Gen Bank登录序列号,与正常人群组口腔黏膜的念珠菌菌株共同建立进化树,观察进化情况,比对分析序列同源性。结果胃黏膜寄居念珠菌阳性率为40.65%(87/214),各组间念珠菌阳性率比较差异有统计学意义(χ2=8.785,P<0.05)。消化性溃疡患者H.pylori与念珠菌同时感染的阳性率(44.44%,24/54)高于慢性胃炎患者(13.46%,29/156)。ITS测序鉴定出6种念珠菌,分别为白色念珠菌71株(80.46%),光滑念珠菌8株(9.20%),热带念珠菌1株(1.15%),克柔念珠菌1株(1.15%),C.caribbica 1株(1.15%),葡萄牙念珠菌7株(8.05%)。慢性胃炎组、溃疡组、正常人群组白色念珠菌菌株的进化树分支方向明显不同。结论沈阳及周边地区上消化道疾病患者胃黏膜感染的念珠菌中白色念珠菌为优势菌种;念珠菌与H.pylori同时感染者有胃黏膜损伤程度加重现象。
Objective To investigate the status of gastric mucosal Candida infection in patients with upper gastrointestinal diseases in Shenyang and Fushun areas. Methods Helicobacter pylori (H.pylori) was detected in 214 cases of upper gastrointestinal diseases in patients with upper gastrointestinal diseases in Shenyang and Fushun by gastroscopy. The Candida albicans was cultured with CHROMagar medium, Candida strains of each group were sequenced by internal transcribed spacer region (ITS) and applied for Gen Bank accession number, and established the phylogenetic tree with Candida strains of oral mucosa in normal population to observe the evolution. Analysis of sequence homology. Results The positive rate of Candida albicans in gastric mucosa was 40.65% (87/214). The positive rate of Candida was statistically significant (χ2 = 8.785, P <0.05). The positive rate of H.pylori and Candida in patients with peptic ulcer (44.44%, 24/54) was higher than that of patients with chronic gastritis (13.46%, 29/156). Candida albicans was identified by ITS sequencing in 71 Candida albicans strains (80.46%), Candida glabrata (9.20%), Candida tropicalis 1 strain (1.15%), Candida krusei 1 strain ), 1 strain of C.caribbica (1.15%) and 7 strains of Candida glabra (8.05%). Chronic gastritis group, ulcer group, the normal population group Candida albicans evolutionary tree branch direction significantly different. Conclusions Candida albicans is the predominant species of Candida in gastric mucosa in patients with upper gastrointestinal diseases in Shenyang and the surrounding areas. Gastric mucosal lesion is aggravated in Candida and H.pylori patients simultaneously.