肝硬化患者无菌腹水中真菌DNA的检测及易位研究

目的检测和分析肝硬化患者无菌腹水中真菌DNA存在状况。方法选取118例无菌腹水的肝硬化患者为研究对象，分别采集患者刚入院时的腹水、血液和粪便标本。应用PCR技术直接检测标本的真菌DNA并克隆测序。并收集患者临床资料，对患者临床症状及检验结果进行分析比较。结果1名患者的腹水、血液、粪便中同时检测到真菌DNA，14名患者的腹水和粪便中同时检测到真菌DNA，3名患者的血液和粪便中同时检测到真菌DNA，大部分序列间的相似性高于99％。测序检测到最多的菌种为Candidaalbicans。结论肝硬化患者无菌腹水中能够检测到真菌DNA，并且提示在肝硬化患者腹水和血清中检测到的真菌DNA易位于肠道。

Detection of fungal DNA in cirrhotic patients with sterile ascites represents episodes of fungal translocation

Objective To detect and analyze the fungal DNA(fungDNA) in patients with cirrhosis and culture-negative non-eutrocytic ascites.Method 118 consecutively admitted cirrhotic patients with culture-negative non-eutrocytic ascites were included in the study.FungDNA in the ascites obtained at the time of admission was detected using a polymerase chain reaction(PCR)-based therapeutic paracentesis,and the serum and fecal samples were also detected and identified by building fungal 18S rDNA-based clone libraries and nucleotide sequencing.These patients were followed-up to assess the clinical characteristics.Result FungDNA was detected simultaneously in all of the three resources,i.e,ascites,serum and feces from 1 patient,in ascites and feces from 14 patients,and in serum and feces from 3 patients.The similarity between the sequences in most cases was more than 99%.The most prevalent fungDNA being identified was from Candida albicans.Conclusion FungDNA can be detected in cirrhotic patients with culture-negative ascites which suggested that the fungDNA in ascites or serum was originated from the gut in patients with culture-negative ascites,representing episodes of fungal translocation.