胃肠病患者幽门螺杆菌感染状况及耐药性分析

Helicobacter Pylori Infection and Drug Resistance in Patients with Gastrointestinal Diseases

目的探讨胃肠病患者幽门螺杆菌(Hp)感染状况、影响因素及耐药性。方法以某医院2013年10月-2015年10月收治的364例胃肠病患者为对象,均采集胃窦粘膜组织进行Hp检测及影响因素分析,采用临界点琼脂稀释法对分离菌株进行药物敏感试验。结果 364例胃肠病患者中Hp感染率为44.78%;不同胃肠病患者Hp阳性率由高到低依次为胃癌55.26%、十二指肠溃疡50.0%、胃溃疡48.48%及慢性胃炎36.36%。单因素分析显示,文化程度高中以下、有吸烟/酗酒史、喜好辛辣食物、有暴饮暴食习惯是Hp感染的危险因素(P<0.05);多因素Logistic回归分析结果显示,文化程度、饮食习惯、辛辣食物、吸烟/酗酒均为Hp感染的危险因素,OR值分别为0.748、0.838、1.469、1.345。药敏试验结果显示,Hp对甲硝唑耐药性最高,为90.18%;其次为左氧氟沙星(68.71%)、克拉霉素(51.53%),对阿莫西林、庆大霉素、痢特灵不耐药。结论胃肠病患者Hp感染率较高,与患者饮食习惯、文化程度等因素显著相关;Hp对甲硝唑、左氧氟沙星等抗菌药有较高耐药性。

Objective To investigate the Helicobacter pylori （Hp） infection and drug resistance in patients with gastrointes- tinal diseases. Methods 364 eases of patients with gastrointestinal diseases who were treated in our hospital between October 2013 and October 2015 were selected as subjects. The mucosa tissues of the gastric antrum were collected from each of these patients to perform Hp detection beforethe influencing factors were analyzed. The drug sensitivity test for isolated strains was carried out by the critical point agar dilution method. Results Among the 364 patients with gastrointestinal diseases, the rate of Hp infection was 44. 78%. The Hp positive rate of gastric cancer was the highest（55.26% ） among gastrointestinal diseases, followed by duodenal ulcer （50. 0% ）, gastric ulcer （48.48%） and chronic gastritis （36.36%）. Univariate analysis showed that an education level below high school, smoking or drinking, preference for hot and spicy food and overeating were risk factors for Hp infection （ P〈0.05 ） while multiva- riate Logistic regression analysis showed that the risk factors of Hp infection were the level of education, eating habits, spicy food, smoking and drinking. The OR values were 0.748, 0. 838, 1. 469 and 1. 345 respectively. The drug sensitive test showed that the drug resistance of Hp to metronidazole was the highest （90.18%） , followed by levofloxacin （68.71% ） and clarithromy- cin （51.53%）. There was no resistance to amoxicillin, gentamicin and furaxone. Conclusion The HP infection rate among pa- tients with gastrointestinal diseases is relatively higher. Its occurrence is significantly correlated with eating habits, levels of edu- cation and other factors. HP has high drug resistance to metronidazole, levofloxacin and other antimicrobial drugs.