本文選題：人芽囊原蟲 + 感染情況�。� 參考：《廣西醫(yī)科大學》2015年碩士論文

【摘要】：目的 了解廣西兩所三甲醫(yī)院住院患者人芽囊原蟲(Blastocystis hominis,B.h)的感染情況；確定住院患者B.h感染株的基因分型,揭示未知基因型B.h分離株的遺傳距離及遺傳多態(tài)性；探討甲硝唑、替硝唑、阿奇霉素、諾氟沙星4種藥物對B.h的作用效果。方法收取廣西三甲醫(yī)院(廣西醫(yī)科大學第一附屬醫(yī)院、廣西醫(yī)科大學附屬腫瘤醫(yī)院,以下分別簡稱一附院和腫瘤醫(yī)院)住院患者新鮮糞便,采用改良酸醚沉淀法,鏡檢定性診斷,用R語言軟件分析住院患者與正常人群、胃腸疾病患者與非胃腸疾病患者、兩所醫(yī)院住院患者性別、職業(yè)、年齡、民族及受教育水平各組間B.h感染率。收集經鑒定的陽性蟲體,37℃厭氧培養(yǎng),提取陽性蟲體DNA；以基因組DNA為模板,采用7對STS特異性引物進行PCR擴增明確其基因分型；把未知基因型分離株作為研究對象應用RAPD標記技術構建條帶圖譜,用NTSYSpc軟件對分離株的遺傳多樣性進行聚類分析,構建聚類分析圖。最后采用MTT法檢測B.h對甲硝唑、替硝唑、阿奇霉素、諾氟沙星的藥敏反應,觀察4種藥物對B.h的作用效果。結果(1)兩所醫(yī)院共檢查住院患者2800例,總陽性率為36.6%。附院與腫瘤醫(yī)院陽性率分別為22.59%、43.24%。與正常人群感染率相比,住院患者感染率高于正常人群(P=0.000)；腫瘤患者與非腫瘤患者、正常人群感染率相比,差異有統(tǒng)計學意義(P=0.000)；按照胃腸科室與非胃腸科室分組,兩組感染率差異有統(tǒng)計學意義(P=0.000)；按照文化程度、職業(yè)劃分,兩所醫(yī)院初中及以下學歷患者(P=0.000)、農民患者感染率較其他文化程度患者感染率差異有統(tǒng)計學意義(P=0.000)；按照性別、年齡、民族分組,兩所醫(yī)院各組間感染率差異沒有統(tǒng)計學意義(P0.05)。(2)STS基因分型結果顯示,共57例標本,有36例標本被分型,其中單純1型2株、單純2型20株、單純3型3株、單純4型3株、單純6型5株、單純7型3株,剩余21例為未知基因型；1型、4型、7型共擴增出8株,且8株均為一附院住院患者分離株,3型3株均為腫瘤醫(yī)院住院患者分離株；一附院與腫瘤醫(yī)院患者STS基因分型已知型占全部例數(shù)的比例分別為87.5%、53.7%,經卡方檢驗差異有統(tǒng)計學意義。RAPD結果顯示21例分離株的遺傳相似系數(shù)Sij在0.615-0.923之間；從聚類分析樹可將21例B.h可劃分為8個枝系。(3)MTT法檢測藥敏實驗結果顯示甲硝唑、替硝唑、阿奇霉素、諾氟沙星4種藥物均對B.h有抑制作用,且隨著濃度的增加(10、20、40、80μg/ml)其平均細胞抑制率是在不斷增加；經R語言軟件計算4種藥物在24h、48h、72h時間段的IC50值,加入藥物24h后,甲硝唑、替硝唑、阿奇霉素、諾氟沙星的IC50值分別為159.77、80.47、162.5、77.27μg/ml;加入藥物48h后,IC50值分別為1147、440.9、2847、169.2μg/ml;加入藥物72h后,IC50值分別為2146、1967、8031、7895μg/ml。結論(1)住院患者感染率較正常人群感染率高,腫瘤患者感染率高于非腫瘤患者和正常人群感染率,胃腸科室住院患者感染率高于非胃腸科室住院患者感染率。(2)在住院患者中存在1、2、3、4、6、7型,未見5型,且2型為優(yōu)勢基因型。(3)21例未知基因型基因結構復雜,遺傳差異明顯。(4)諾氟沙星對抑制B.h的生長與繁殖作用明顯。
[Abstract]:Objective to understand the infection of Blastocystis hominis (Blastocystis hominis, B.h) in two hospital inpatients and determine the genotype of B.h infected strains in hospitalized patients, to reveal the genetic distance and genetic polymorphism of unknown genotype B.h isolates, and to explore the effect of metronidazole, nitazazole, azithromycin and norfloxacin on B.h. Methods the fresh feces of hospitalized patients were collected from the First Affiliated Hospital of Guangxi (the First Affiliated Hospital of Guangxi Medical University, the tumor hospital affiliated to Guangxi Medical University, the following abbreviated hospital and cancer hospital). The modified acid ether precipitation method, the microscopic examination diagnosis, and the R language soft parts were used to analyze the hospitalized patients and the normal population and the patients with gastrointestinal diseases. In patients with non gastrointestinal diseases, the B.h infection rates of B.h were collected between the sexes, professions, ages, ethnic groups and education levels. The positive insect body was collected and the positive insect body DNA was extracted at 37 C, and the genomic DNA was used as a template, and 7 STS specific primers were used to identify the genotyping by PCR amplification; the unknown genotypes were divided. The isolated strain was used as the research object to construct a strip map with RAPD marker technique. The genetic diversity of the isolates was analyzed by NTSYSpc software and the cluster analysis was constructed. Finally, the drug sensitivity of B.h to metronidazole, tinidazole, azithromycin, norfloxacin was detected by MTT, and the effect of 4 drugs on B.h was observed. Results (1) two medical treatments. The total positive rate of the hospitalized patients was 2800 cases, the positive rate of the total positive rate was 22.59% in the 36.6%. hospital and the tumor hospital. Compared with the normal population, the infection rate of the hospitalized patients was higher than that of the normal population (P=0.000). The rate of infection in the tumor patients and the non tumor patients was compared with the normal population (P=0.000), and the difference was statistically significant (P=0.000). The difference of infection rate between the two groups was statistically significant (P=0.000). According to the educational level, occupation division, two hospital junior high school and below education patients (P=0.000), the infection rate of the farmers was statistically significant (P=0.000) compared with the other cultural degree patients (P=0.000); according to sex, age, national group, two hospitals There was no significant difference in infection rate between each group (P0.05). (2) the results of STS genotyping showed that there were 57 specimens and 36 specimens were classified as simple 1, 20, only 3, 3, only 4, 3, purely 6 5, pure 7. The isolated strains of hospitalized patients and 3 strains of type 3 were all isolated strains of inpatients in the cancer hospital. The proportion of the known STS genotypes of the patients in the hospital and the cancer hospital was 87.5% and 53.7% respectively. The difference of the chi square test was statistically significant.RAPD results showed that the genetic similarity coefficient Sij of the 21 isolates was between 0.615-0.923; The cluster analysis tree could divide 21 B.h cases into 8 branches. (3) the test results of MTT assay showed that metronidazole, tinidazole, azithromycin, and norfloxacin had inhibitory effects on B.h, and the average cell inhibition rate was increasing with the increase of concentration (10,20,40,80 mu g/ml); 4 drugs were calculated by R language software in 24h, 4 After adding drug 24h, the IC50 value of metronidazole, tinidazole, azithromycin and norfloxacin was 159.77,80.47162.5,77.27 g/ml respectively after adding the IC50 value of the drug 24h, and the IC50 value was 1147440.92847169.2 u g/ml, respectively after adding drug 48h, after adding drug 72h, the value was 2146196780317895 micron conclusion (1) in hospitalized patients. The infection rate of the normal population is high, the infection rate of the tumor patients is higher than that of the non tumor patients and the normal population. The infection rate of the hospitalized patients in the gastrointestinal department is higher than that in the non gastrointestinal department. (2) there is a 1,2,3,4,6,7 type in the hospitalized patients, no type 5, and the 2 type is the dominant genotype. (3) 21 cases of unknown genotypes are complex and genetic difference. (4) norfloxacin significantly inhibited the growth and reproduction of B.h.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R446.5

【參考文獻】

相關期刊論文 前10條

1 何建國,訌靜波;人芽囊原蟲空泡型和顆粒型超微結構的研究[J];動物學報;1993年01期

2 田春林;萬孝玲;劉曉泉;;三種藥物對體外人芽囊原蟲的作用效果觀察[J];中國熱帶醫(yī)學;2007年03期

3 周建璽,李毓忠,杜涓,周向東,劉備戰(zhàn);諾氟沙星膠囊治療腸道蛔蟲病1例[J];武警醫(yī)學;1998年06期

4 劉常華,謝紅,鄭德福;四川省人芽囊原蟲感染情況調查[J];現(xiàn)代預防醫(yī)學;1998年01期

5 薛長貴;機會致病性寄生蟲感染[J];中國微生態(tài)學雜志;2001年04期

6 金群馨,唐國都,俞開敏;人芽囊原蟲病患者腸粘膜損傷及其粘膜細胞因子的測定[J];中國寄生蟲病防治雜志;2005年05期

7 辛玲;崔巍;梁瑞文;汲蕊;孫秀寧;李瑞芳;;惡性腫瘤患者隱孢子蟲感染情況調查[J];中國病原生物學雜志;2007年04期

8 俞開敏;;人芽囊原蟲病患者腸黏膜表皮生長因子水平及其臨床意義[J];中國病原生物學雜志;2011年06期

9 何妮,張月清,洪明理,叢敏;人芽囊原蟲的形態(tài)與超微結構[J];中國寄生蟲學與寄生蟲病雜志;2001年03期

10 張紅衛(wèi);李文;顏秋葉;賀麗君;蘇云普;;人芽囊原蟲對實驗感染昆明小鼠腸黏膜超微結構的影響[J];中國寄生蟲學與寄生蟲病雜志;2006年03期

相關碩士學位論文 前1條

1 楊彥;廣西南部沿海地區(qū)人群人芽囊原蟲感染情況調查與基因型初步研究[D];廣西醫(yī)科大學;2011年

，

本文編號：1937505