我国幽门螺杆菌临床诊疗现状的调查研究

A study on the current situation of clinical diagnosis and treatment of Helicobacter pylori in China

目的调查研究我国幽门螺杆菌(H.pylori)诊断方法与治疗药物的临床应用等现状,并探讨适合我国国情的H.pylori个体化诊疗与首次成功根除技术路径。方法选择中国医药生物技术协会慢病管理分会幽门螺杆菌与慢性胃病工作组成员所在单位(34家医院和中国幽门螺杆菌分子医学中心)进行问卷调查和分析。问卷调查内容包括H.pylori诊断方法开展、院内抗生素使用、H.pylori专病门诊开设和菌株库建立情况。采用描述性方法进行统计学分析。结果H.pylori诊断方法开展方面,快速尿素酶试验、病理学诊断、药敏试验、尿素呼气试验、粪便抗原检测、血清学检测、胃蛋白酶原检测、耐药基因检测(包括有意向开展)在34家医院的开展率分别为47.1%(16/34)、47.1%(16/34)、64.7%(22/34)、100.0%(34/34)、38.2%(13/34)、88.2%(30/34)、97.1%(33/34)和44.1%(15/34)。院内抗生素使用方面,阿莫西林、克拉霉素、左氧氟沙星、甲硝唑、呋喃唑酮和四环素在34家医院中的使用率分别为100.0%(34/34)、97.1%(33/34)、97.1%(33/34)、91.2%(31/34)、52.9%(18/34)和44.1%(15/34)。34家医院中有25家(73.5%)设立H.pylori专病门诊,14家(41.2%)建立H.pylori菌株库。结论我国多数地区H.pylori尿素呼气试验已普及,粪便抗原检测、快速尿素酶试验和病理学诊断待加强;呋喃唑酮和四环素的可及性较低,值得关注;较多医院已设立H.pylori专病门诊,并进行药敏试验和耐药基因检测,建立菌株库,为个体化诊疗和首诊根除H.pylori技术路径的研究、制订和实施奠定了重要基础。

ObjectiveTo investigate the current status of diagnostic methods and therapeutic drugs of Helicobacter pylori(H.pylori)in China,and to explore technical pathways suitable in China for personalized diagnosis and treatment,and the first successful eradication of H.pylori.MethodsA questionnaire survey was carried out in the workplaces of members of Helicobacter pylori and Chronic Gastric Disease Group of Chronic Disease Management Branch of China Pharmaceutical Biotechnology Association(34 hospitals and China Center for Helicobacter pylori Molecular Medicine).The questionnaire survey included the development of diagnostic methods of H.pylori,the usage of antibiotics in hospitals,the establishment of H.pylori spcialized clinics,and the establishment of H.pylori strain banks.Descriptive methods were used for statistical analysis.ResultsIn terms of H.pylori diagnosis methods,the development rates of rapid urease test,pathological diagnosis,antibiotic sensitive test,urea breath test,fecal antigen test,serological test,pepsinogen test,and drug resistance genetic test(including intention to perform)in 34 hospitals were 47.1%(16/34),47.1%(16/34),64.7%(22/34),100.0%(34/34),38.2%(13/34),88.2%(30/34),97.1%(33/34)and 44.1%(15/34),respectively.Regarding the usage of antibiotics in hospitals,the usage rates of amoxicillin,clarithromycin,levofloxacin,metronidazole,furazolidone and tetracycline in 34 hospitals were 100.0%(34/34),97.1%(33/34),97.1%(33/34),91.2%(31/34),52.9%(18/34)and 44.1%(15/34),respectively.Among 34 hospitals,H.pylori-specialized clinics were set up in 25 hospitals(73.5%)and H.pylori strain banks were built up in 14 hospitals(41.2%).ConclusionsH.pylori urea breath test is widely used in China,while fecal antigen test,rapid urease test and pathological diagnosis need to be strengthened.The low accessibility of furazolidone and tetracycline deserves attention.Specialized clinics for H.pylori have been set up in many hospitals,and antibiotic sensitivity and genetic test of drug resistance have been carried out,strain banks have been built up,laying on important foundation for the research,development and implementation of personalized diagnosis and treatment and H.pylori eradication technology.