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| 安徽淮南地区160例幽门螺杆菌培养结果分析及药敏试验指导临床治疗的效果研究 |
| Analysis of Helicobacter pylori culture results of 160 cases in Huainan area of Anhui Province and study on the effect of drug susceptibility test in guiding clinical treatment |
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| DOI：10.3969/j.issn.1007-8134.2022.05.013 |
| 中文关键词: 安徽淮南地区 幽门螺杆菌 培养 耐药性 血清学水平 药敏试验 抗菌药物 不良反应 |
| 英文关键词: Huainan area of Anhui Helicobacter pylori culture drug resistance serological level drug susceptibility test antibacterial drug adverse reaction |
| 基金项目:安徽省卫生健康委科研项目立项项目（AHWJ2020091） |
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| 中文摘要: |
| [摘要]?目的?了解安徽淮南地区幽门螺杆菌（Helicobacter Pylori, HP）培养及耐药状况，为临床诊治HP感染提供实验室依据。方法?选择2020年7月—2021年12月于淮南东方医院集团总医院就诊的160例消化性溃疡患者为研究对象，取胃窦黏膜病灶组织进行HP培养及药物敏感性（药敏）试验，并分析结果。按照随机数字表法，将HP培养阳性患者分为对照组和观察组。其中对照组采用常规/经验四联疗法治疗方案（阿莫西林胶囊、克拉霉素、奥美拉唑、枸橼酸铋钾胶囊），观察组在对照组基础上根据药敏试验选择耐药率较低的抗菌药物四联疗法方案（甲硝唑、呋喃唑酮、奥美拉唑、枸橼酸铋钾胶囊）指导临床治疗，2组患者均完成2周药物治疗，比较2组血清胃泌素-17（gastrin-17, G-17）、胃蛋白酶原I（pepsinogen I, PGI）、胃蛋白酶原II（pepsinogen II, PGII）水平，HP根除率及不良反应情况。结果?160例患者完成HP培养，其中56例患者阳性，阳性率为35.00%（56/160）。药敏试验结果表明，耐药率排在前2位的抗菌药物分别为左氧氟沙星（96.43%，54/56）和四环素（92.86%，52/56）。对照组和观察组治疗前血清G-17、PGI及PGII水平比较差异均无统计意义（P均＞0.05），治疗2周后，血清G-17、PGI及PGII水平均低于治疗前（P均＜0.05）。观察组治疗2周后血清G-17、PGI及PGII水平下降幅度均高于对照组（P均＜0.05）。观察组疗程完毕后，随访4、8、12个月时HP根除率均高于对照组（P均＜0.05）。2组用药期间不良反应发生率比较差异无统计意义（P＞0.05）。结论?安徽淮南地区HP感染后培养阳性率较高，且对左氧氟沙星、四环素等抗菌药物耐药率较高。HP培养阳性的消化性溃疡患者应根据药敏试验结果合理选择应用抗菌药物，不仅有助于改善血清学水平，提高HP根除率，而且用药安全性较高。 |
| 英文摘要: |
| [Abstract] Objective To understand the culture and drug resistance of Helicobacter pylori (HP) in Huainan, Anhui Province, and to provide laboratory basis for clinical diagnosis and treatment of HP infection. Methods?One hundred and sixtypatients with peptic ulcer who were treated at Huainan Oriental Hospital Group General Hospital from July 2020 to December 2021 were selected. The gastric antrum mucosal lesions were collected for HP culture and drugs sensitivity (drug susceptibility) test, and the results were analyzed. According to the random number table method, the patients with positive HP culture were divided into the control group and the observation group. The control group was treated with conventional/empirical methods (amoxicillin capsule, clarithromycin, omeprazole, bismuth potassium citrate capsule ), and the observation group selected the antibacterial quadruple therapy (metronidazole, furazolidone, omeprazole, bismuth potassium citrate capsules ) with low drug resistance rate based on the drug susceptibility test to guide the clinical treatment. Both groups completed 2 weeks of treatment. The levels of serum gastrin-17 (gastrin-17, G-17), pepsinogen I ( pepsinogen I, PGI) and pepsinogen II (pepsinogen II, PGII), HP eradication rates and adverse reaction rates of 2 groups were compared. Results?One hundred and sixty patients completed HP culture, 56 of them were positive, the positive rate was 35.00% (56/160). The results of drug sensitivity test showed that the top 2 antibiotics with drug resistance were levofloxacin (96.43%, 54/56) and tetracycline (92.86%, 52/56). There was no statistically significant difference between the control group and the observation group in the levels of serum G-17, PGI and PGII before treatment (P＞0.05), after 2 weeks of treatment, the levels of serum G-17, PGI and PGII were lower than those before treatment (P＜0.05). After 2 weeks of treatment, the levels of serum G-17, PGI and PGII in the observation group decreased more than those in the control group (P＜0.05). After the course of treatment, the eradication rate of HP in the observation group was higher than that in the control group at 4, 8 and 12 months of follow-up (P＜0.05). There was no significant difference in the incidence of adverse reactions between the 2 groups (P＞0.05). Conclusions?The positive rate of HP culture after infection in Huainan area of Anhui is high, and the resistance rates to levofloxacin, tetracycline and other antibiotics are high. In patients with HP culture-positive peptic ulcer, antibiotics should be reasonably selected according to the drug susceptibility test results, which not only helps to improve the serological level and the HP eradication rate, but also has high drug safety. |
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