影响消化性溃疡患者HP根除率的危险因素分析

目的分析影响消化性溃疡患者幽门螺杆菌(Hp)根除率的危险因素。方法选取我院收治的260例消化性溃疡患者,均采取四联疗法进行初次根除治疗,按照Hp根除结果将其分为成功组(n=235)与失败组(n=25),比较两组临床资料、治疗依从性,分析影响Hp根除率危险因素。结果两组患者性别、年龄、BMI、饮酒史、文化程度、职业类型、病变类型比较无明显差异(P>0.05);成功组患者中无吸烟史、弱代谢型CYP2C1基因多态性、阿莫西林敏感、呋喃唑酮敏感所占比例明显高于失败组(P<0.05);成功组治疗完全依从率86.38%,显著高于失败组64.00%(P<0.05);Logistic多因素分析显示,有吸烟史、CYP2C19基因多态性为强代谢型、呋喃唑酮耐药、治疗依从性低为影响HP根除率危险因素(P<0.05)。结论有吸烟史、CYP2C19基因多态性为强代谢型、呋喃唑酮耐药、治疗依从性低属于消化性溃疡患者Hp根除率独立危险因素。

Risk Factors Affecting HP Eradication Rate of Patients With Peptic Ulcer

Objective To analyze the risk factors affecting Helicobacter pylori (Hp) eradication rate of patients with peptic ulcer. Methods 260 patients with peptic ulcer admitted to the hospital were selected. All of them were treated with quartet therapy for primary eradication treatment. According to the result of HP eradication, they were divided into successful group ( n =235 ) and failed group ( n =25). The clinical data, treatment compliance in the two groups were compared. The risk factors affecting HP eradication rate were analyzed. Results There were no significant difference in gender, age, BMI, drinking history, education level, occupational type and lesion type between the two groups ( P >0.05). The proportion of no smoking history, polymorphism of weak metabotropic CYP2C19 gene, the sensitivity of amoxicillin and furazolidone in the successful group was significantly higher than that of the failure group ( P <0.05). The complete treatment compliance rate of the successful group was 86.38%, significantly higher than that of the failure group (64.00%)( P <0.05). Logistic multivariate analysis showed that smoking history, polymorphism of CYP2C19 gene with strong metabotropic, drug resistant to furazolidone and low treatment compliance were the risk factors affecting Hp eradication rate ( P <0.05). Conclusion Smoking history, polymorphism of CYP2C19 gene with strong metabotropic, drug resistant to furazolidone and low treatment compliance are the independent risk factors for Hp eradication rate of patients with peptic ulcer.