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目的:了解肺病患者呼吸道曲霉基因分型状况,寻找肺部曲霉感染的可能来源,为曲霉感染的防治提供参考。方法:选择有呼吸道症状的患者925例作受试对象,收集其鼻腔、咽部分泌物及支气管肺泡灌洗液(bronchoal veolar lavage fluid,BALF)进行真菌培养、鉴定及随机扩增多态性DNA(random amplified polymorphic DNA,RAPD)基因分型分析。结果:在烟曲霉、黄曲霉和黑曲霉的RAPD带形图中,扩增条带数在1～11条之间,片断大小在150bp～2kb不等,不同菌株之间扩增条带的数量和扩增片断的大小均存在差异,即使带型完全一致的菌株,有些片断也存在亮度的差异。对分离自同一患者呼吸道不同部位的同种曲霉种内相似性比较的结果显示:虽然来自同一患者呼吸道不同部位的同种曲霉的形态学特征相同,但是基因型特征却存在差异。结论:通过呼吸作用进入肺组织内部的曲霉与患者鼻腔定植的同种曲霉存在差异,提示肺部曲霉的感染可能来源于患者周围的环境中,有效的控制环境中曲霉的污染程度是预防肺部曲霉感染的最有利的手段。
OBJECTIVE: To understand the genotypes of Aspergillus oryzae in patients with lung disease, to find out the possible sources of Aspergillus infection in lung and to provide reference for the prevention and treatment of Aspergillus infection. Methods: A total of 925 patients with respiratory symptoms were enrolled in this study. Nasal and pharyngeal secretions and bronchoalveolar lavage fluid (BALF) were collected for fungal culture, identification and random amplified polymorphic DNA (random amplified polymorphic DNA, RAPD) genotyping analysis. Results: In the band diagram of RAPD of Aspergillus fumigatus, Aspergillus flavus and Aspergillus niger, the numbers of amplified bands ranged from 1 to 11 and the sizes of fragments varied from 150 bp to 2 kb. The number of amplified bands And the size of the amplified fragments are different, even with the same band type strains, some fragments also have brightness differences. Comparison of intraspecific similarities among isolates of the same species isolated from different parts of the respiratory tract of the same patient showed that although the same aspergillus species from different parts of the respiratory tract of the same patient had the same morphological characteristics, there were differences in genotypic characteristics. CONCLUSIONS: Aspergillus entering the lung tissue through respiration is different from the aspergillus colonized in the nasal cavity of patients, suggesting that the infection of Aspergillus pleuromum may originate from the environment around the patient, and that the effective control of Aspergillus contamination in the environment is to prevent the lung Aspergillus infection is the most favorable means.