海军潜艇官兵幽门螺杆菌感染及耐药情况分析

Analysis of Helicobacter pylori Infection and Drug Resistance in Submarine Officers and Soldiers

目的了解海军潜艇官兵幽门螺杆菌(Helicobacter pylori,H.pylori)的感染和对常用抗生素的耐药情况,为合理选用治疗方案提供依据。方法以2013-09/2014-08月某军队218例有上消化道疾病的潜艇官兵为研究对象,并以同时期另外218名上消化道疾病的陆勤官兵为对照,通过胃镜钳取胃粘膜进行H.pylori培养和E-test比较两组官兵H.pylori总体感染率和不同病种的H.pylori阳性率,并观察菌株对6种常用抗生素的耐药情况。结果潜艇官兵胃粘膜标本共培养出幽门螺杆菌175株,感染率高达80.3%,其中浅表性胃炎76.5%、萎缩性胃炎79.3%、消化性溃疡91.9%,总感染率和单病种感染率均高于陆勤官兵,各项指标的差异均有统计学意义;潜艇官兵H.pylori对常用抗生素的耐药率普遍高于陆勤官兵,其中甲硝唑耐药率达68.0%,四环素仅为2.3%,与陆勤官兵比较,左氧氟沙星和阿莫西林的耐药率差异有统计学意义。结论海军潜艇官兵幽门螺杆菌感染率、耐药性高和根治率低,临床治疗需结合个体情况制定联合方案以提高H.pylori的根治率。

Objective To study the status quo of helicobacter pylori(H.pylori)infection and drug resistance in submarine officers and solders,and provided the basis for clinical rational drug using.Methods A total of 218 submarine officers and solders with disease of upper gastrointestinal tract were selected from September 2013 to August 2014.Another218 onshore officers and solders were selected as contrast group.Gastric mucosa were clamped by gastroscope and cultivated.E-test was used to compare the drug resistance of 6 antibiotics between them.Results There were 175 H.pylori plant and the positive rate was 80.3% in submarine officers and solders.Among those patients,gastric ulcer was the highest(91.9%),and followed by atrophic gastritis(79.3%)and superficial gastritis(76.5%).All indexs were higher than onshore officers and solders(P<0.05).The submarine officers and solders had high drug resistance rate to common antibiotics,and metronidazole was the highest(68.0%)the tetracycline was the lowest(2.3%).There was statistical significance in drug resistance rate of levofloxacin and amoxicillin between the two groups.Conclusion H.pylori has high injection rate,high drug resistance and with low cure rate in submarine officers and solders.Individualized treatment should be used when therapeutic schedule is made so as to enhance eradicate rate.