难治性胃炎患者幽门螺旋杆菌耐药性分析

Analysis of Drug Resistance of Helicobacter Pylori in Patients with Refractory Gastritis

目的分析难治性胃炎患者幽门螺旋杆菌(Hp)的耐药性。方法选取2013年2月-2015年3月我院收治的难治性胃炎患者80例,实施胃镜下黏膜活检,确定炎症分度与病理分型,检测不同病理类型胃炎Hp感染率,并分析Hp感染的影响因素进行药物敏感试验评价Hp对不同抗菌药物的耐药率,分析影响因素与耐药的相关性。结果萎缩性胃炎Hp感染率高于糜烂性及浅表性胃炎(P<0.05);性别、年龄、吸烟史及炎症分度为Hp感染的影响因素(P<0.05)。Hp对甲硝唑、左氧氟沙星、克拉霉素的耐药率分别为97.1%、66.7%、60.0%对阿莫西林及庆大霉素不耐药。年龄、炎症分度、吸烟频度、Hp根除次数均与Hp耐药性呈正相关(r=0.952、0.751、0.357、0.843,P<0.05)。结论难治性胃炎中萎缩性胃炎Hp感染率较高,Hp感染率受年龄影响较大,且对甲硝唑高度耐药。

Objective To analyze the drug resistance of Helicobacter pylori （Hp） in patients with refractory gastritis. Methods Eighty patients with refractory gastritis who were admitted to our hospital between February 2013 and March 2015 were selected as subjects. Continuous mucosal biopsy under a gastroscope was performed in all the patients to determine the inflamma- tion grade and pathological type of gastritis before the factors influencing Hp infection were analyzed. Meanwhile, a drug sensitivity test was carried out on the obtained Hp, and the influencing factors were analyzed. Results The HP infection rate of atrophic gas- tritis was significantly higher than that of erosive and superficial gastritis （ P〈0.05 ）. Gender, age, smoking history and inflamma- tion grade could affect the Hp infection rate（P〈0.05）. The drug resistance rate of HP to different antimicrobial agents was 97. 1% for metronidazole, 66.7% for levofloxacin and 60.0% for clarithromycin. There was no resistance to amoxicillin or gentami- cin. Correlation analysis showed that age,inflammatory grade, smoking frequency, and Hp eradication times were positively corre- lated with drug resistance of Hp （r=0. 952,0. 751,0. 357,0. 843 ,P〈0. 05 ）. Conclusion In each type of refractory gastritis, the Hp infection rate of atrophic gastritis is relatively high. The Hp infection rate is significantly affected by age, and Hp is highly re- sistant to metronidazole.