慢性阻塞性肺疾病患者幽门螺杆菌耐药状况研究

发布时间：2018-06-09 15:55

本文选题：螺杆菌 + 幽门　；参考：《重庆医学》2017年21期

【摘要】：目的研究慢性阻塞性肺疾病(COPD)感染幽门螺杆菌(Hp)患者对常用抗菌药物的耐药状况及四联抗Hp疗法的临床疗效。方法收集2012年8月至2014年12月该院住院及门诊确诊的Hp感染患者180例,其中COPD患者(COPD组)与非COPD患者(对照组)各90例。所有患者胃镜下取胃窦部黏膜组织进行Hp培养、鉴定,观察各组对克拉霉素、甲硝唑、阿莫西林、左氧氟沙星、呋喃唑酮的耐药情况;此外,根据不同的给药方案将两组均分为A、B、C 3个亚组,分别给予包含阿莫西林+克拉霉素(A组)、阿莫西林+左氧氟沙星(B组)、阿莫西林+呋喃唑酮(C组)的3种四联方案,比较临床疗效。结果对照组患者感染Hp菌株对克拉霉素的、甲硝唑、阿莫西林、左氧氟沙星的耐药率分别为21.11%、55.56%、3.33%、5.56%,而COPD组患者感染Hp菌株对上述抗菌药物的耐药率依次为26.67%、57.78%、7.78%、16.67%,两组均未发现对呋喃唑酮耐药的Hp菌株;两组左氧氟沙星及总双重耐药率比较,差异均有统计学意义(P0.05)。对照组3个亚组应用3种四联方案的根除率分别为A组90.0%、B组96.7%、C组100.0%,而COPD组分别为86.7%、80.0、96.7%;两组采用B组方案的患者Hp根除率比较,差异有统计学意义(P0.05)。结论 COPD患者感染Hp对左氧氟沙星耐药率有增高趋势,应谨慎使用,包含阿莫西林+呋喃唑酮的四联方案可作为COPD患者初次Hp根除治疗的优选方案。
[Abstract]:Objective to study the drug resistance of patients with Helicobacter pylori (HP) infection in patients with chronic obstructive pulmonary disease (COPD) and the clinical efficacy of quadruple anti-HP therapy. Methods from August 2012 to December 2014, 180 patients with HP infection were collected, including 90 patients with COPD and 90 patients with non-COPD (control group). All the gastric antral mucosa tissues were harvested under gastroscopy for HP culture and identification. The drug resistance of each group to clarithromycin, metronidazole, amoxicillin, levofloxacin, furazolidone was observed, and the drug resistance of each group to clarithromycin, metronidazole, amoxicillin, levofloxacin, furazolidone was observed. The two groups were divided into three subgroups: Amoxicillin clarithromycin group A, amoxicillin levofloxacin group B and amoxicillin furazolidone group C, respectively. To compare the clinical efficacy. Results the patients in the control group were infected with clarithromycin, metronidazole, amoxicillin. The drug resistance rates of levofloxacin were 21.1155.56 and 5.56, respectively. In COPD group, the resistance rates of H. pylori to the above antibiotics were 26.677.78 and 16.67, respectively. There were no strains resistant to furazolidone in both groups, and the rates of levofloxacin and total double drug resistance were compared between the two groups. The difference was statistically significant (P 0.05). The eradication rate of three tetralogy regimens in the control group was 90.0 and 96.7 in group B and 86.70.96. 7 in group C, respectively, while that in COPD group was 86.70.The eradication rate of HP in group B was significantly higher than that in group B (P 0.05). Conclusion the incidence of levofloxacin resistance to levofloxacin in COPD patients with HP infection is increasing and should be used carefully. The quadruple regimen including amoxicillin furazolidone can be used as the optimal regimen for the first HP eradication therapy in COPD patients.
【作者单位】：重庆市江津区中心医院消化内科;
【基金】：重庆市卫生局医学科研计划面上项目(2011-2-450)
【分类号】：R563.9

【参考文献】