Abstract: Objective To identify Plasmodium falciparum chloroquine resistant transporter (Pfcrt)point mutations and P. falciparum multidrug resistance 1 (pfmdr1)and their correlation in imported P. falciparum. Methods Blood samples were collected from returnees infected with P. falciparum in endemic areas of Africa and Southeast Asia during 2009-2016 in Wuhan city. The Pfcrt76 gene and pfmdr1 gene were amplified by nested PCR, and the products were digested by restriction endonuclease ApoⅠ, AseⅠ and EcoRv. The mutation rate was analyzed. Results A total of 232 patients with falciparum malaria were involved in the study. The mutation rates for Pfcrt76, pfmdr1 loci 86, 1042, and 1246 were 55.2%, 17.2%, 5.2%, and 8.6% respectively, the total mutation rate for pfmdr1 was 26.3%. The mutation rates for pfmdr1 loci 86, 1042, 1246 and pfmdr1 were 28.6%, 3.8%, 12.4%, and 36.2%, respectively in the samples with mutation in Pfcrt76, but 10.4%, 2.1%, 7.3%, and 17.7%, respectively in the samples without mutation in Pfcrt76 from Africa. The linkage disequilibrium analysis between symptoms and the mutations of Pfcrt76, pfmdr186, 1042, and 1246 were conducted, and the value of D'and r² were 0.230 and 0.018, 0.290 and 0.004, 0.996 and 0.012, 0.150 and 0.035, respectively, for each mutation. Conclusion The pfmdr1 mutation sites between Africa and Southeast Asia have statistically significant differences. Pfcrt76 was positively correlated with pfmdr1 mutation and pfmdr186 point mutation.

Key words: Imported cases, Plasmodium falciparum, P. falciparum chloroquine resistant transporter gene, P. falciparum multidrug resistance 1 gene, Gene mutation

摘要： 目的 了解输入性恶性疟原虫氯喹抗性转运蛋白基因（Pfcrt）和恶性疟原虫多药抗性基因1（pfmdr1）相关位点突变情况及其关联性。方法 2009－2016年，采集武汉市从非洲和东南亚等回国人员恶性疟患者血样，利用巢式PCR扩增恶性疟原虫Pfcrt和pfmdr1基因，分别用限制性内切酶ApoⅠ、AseⅠ和EcoRv对产物进行酶切，分析相关位点的突变性。结果 232例输入性恶性疟患者Pfcrt76和pfmdr186、1042、1246位点的突变率分别为55.2%、17.2%、5.2%和8.6%，pfmdr1总突变率为26.3%；东南亚患者血样未检出pfmdr186和pfmdr11246位点突变；非洲输入性恶性疟患者Pfcrt76突变和未突变中pfmdr186、1042、1246位点及pfmdr1总突变率分别为28.6%、3.8%、12.4%、36.2%和10.4%、2.1%、7.3%、17.7%。患者症状与Pfcrt76、pfmdr186、1042、1246位点突变连锁不平衡分析，D'和r²分别为0.230和0.018、0.290和0.004、0.996和0.012、0.150和0.035。结论 输入地为非洲和东南亚缅甸的恶性疟原虫pfmdr1基因突变位点存在差异，Pfcrt76突变与pfmdr1突变和pfmdr186点突变呈正相关。

关键词: 输入病例, 恶性疟原虫, 恶性疟原虫氯喹抗性转运蛋白基因, 恶性疟原虫多药抗性基因1, 基因突变