河西走廊地区上消化道疾病患者幽门螺杆菌耐药性分析

目的研究河西走廊地区上消化道疾病患者幽门螺杆菌(Hp)的感染及对抗生素的耐药状况。方法收集武威、金昌、张掖三地患者的胃黏膜标本,微需氧培养分离Hp,K-B纸片法检测Hp对6种抗菌药物的耐药性。结果从314例患者中分离出Hp 81株,分离率25.80%;消化性溃疡患者中Hp的分离阳性率(46.43%)显著高于慢性胃炎组(23.32%)(P<0.05),15～30岁年龄组人群Hp分离阳性率(52.63%)显著高于61岁以上年龄组(13.16%)(P<0.05)。Hp对常用6种抗菌药物的耐药性依次为:甲硝唑(47.89%),左氧氟沙星(8.45%),阿莫西林(4.23%),四环素(2.82%),克拉霉素(1.41%),呋喃唑酮(0)。胃癌组分离的Hp对左氧氟沙星的耐药率(37.50%)显著高于慢性胃炎组(3.85%)。结论 Hp感染在河西走廊地区上消化道疾病中伴有重要角色;该地区流行的Hp对甲硝唑耐药率较高,在一线根除方案中应尽量避免使用该药物;呋喃唑酮、阿莫西林等可以作为根除治疗的主要药物。

Analysis of the drug resistance of Helicobacter pylori in patients with upper gastrointestinal symptoms in Hexi Corridor

Objective To analyze Helicobacter pylori infection and drug resistance in patients with upper gastrointestinal symptoms in Hexi Corridor.Methods H.pylori strains were isolated from gastric biopsy specimens collected in hospitals in Wuwei,Jinchang,and Zhangye under microaerophilic conditions and the resistance of H.pylori to Amoxicillin,Clarithromycin,Levofloxacin,Metronidazole,Furazolidone,and Tetracycline was observed using the Kirby-Bauer method.Results In total,81 H.pylori strains were isolated from 314 patients,so patients tested positive at a rate of 25.80%.Patients with a peptic ulcer tested positive for H.pylori at a significantly higher rate(46.43%)than did patients with chronic gastritis(23.32%)(P<0.05).Patients ages 15-30 tested positive at a higher rate(52.63%)than did patients age 61 and over(13.16%)(P<0.05).Rates of resistance to antimicrobials were as follows: Metronidazole(47.89%),Levofloxacin(8.45%),Amoxicillin(4.23%),Tetracycline(2.82%),Clarithromycin(1.41%),and Furazolidone(0%).Patients with gastric cancer had H.pylori with significantly higher antimicrobial resistance(37.50%)than did patients with chronic gastritis(3.85%).Conclusion H.pylori infection plays an important role in the incidence of gastrointestinal diseases.Metronidazole should not be used as a first-line agent for H.pylori treatment in the area due to the high resistance of H.pylori to the antibiotic.Furazolidone and Amoxicillin should be used as first-line agents to eradicate H.pylori infection.