CYP2C19 基因多态性与 6~ 14 岁儿童幽门螺杆菌感染铋剂四联方案 疗效的关系

目的:探讨 CYP2C19 基因多态性与 6~14 岁儿童幽门螺杆菌(Hp)感染铋剂四联方案疗效的关系。 方法:选取 2020 年 2 月至 2022 年 9 月我院消化内科门诊确诊为 Hp 感染的 138 例患儿为研究对象,均采用铋剂四联方案治疗(奥美拉唑+阿莫西 林+克拉霉素+枸橼酸铋钾)。 检测患儿 CYP2C19 基因多态性,并根据基因检测结果分为强代谢(EM)组、中间代谢(IM)组和弱 代谢(PM)组,比较 3 组患儿临床疗效、Hp 根除率及不良反应发生情况。 结果:患儿 CYP2C19 基因 EM 型、IM 型及 PM 型的分 布频率分别为 39. 13%、42. 75%、18. 12%。 IM 组和 PM 组总有效率及 Hp 根除率均高于 EM 组(P<0. 05),IM 组和 PM 组总有效 率及 Hp 根除率比较差异无统计学意义(P>0. 05)。 EM 组和 IM 组不良反应总发生率均低于 PM 组(P<0. 05),EM 组和 IM 组不 良反应总发生率比较差异无统计学意义(P>0. 05)。 结论:不同 CYP2C19 基因表型的 Hp 感染患儿通过铋剂四联方案治疗后的 疗效及不良反应存在差异,IM 型及 PM 型患儿疗效较显著,EM 型患儿疗效较差,但 PM 型患儿易出现不良反应。

Correlation between CYP2C19 Gene Polymorphism and Efficacy of Bismuth Quadruple Therapy in the Treatment of Helicobacter Pylori in Children Aged from 6 to 14 Years

Objective: To probe into the correlation between CYP2C19 gene polymorphism and efficacy of bismuth quadruple therapy in the treatment of Helicobacter pylori ( Hp) in children aged from 6 to 14 years. Methods: Totally 138 children with Hp infection diagnosed in the Gastroenterology Department of our hospital from Feb. 2020 to Sept. 2022 were extracted to be treated with bismuth quadruple therapy (omeprazole+amoxicillin+clarithromycin+bismuth potassium citrate). CYP2C19 gene polymorphism of the children was detected, and all patients were divided into the extensive metabolic (EM) group, intermediate metabolic ( IM) group and poor metabolic (PM) group according to different gene detection results. The clinical efficacy, Hp eradication rate and adverse drug reactions of three groups were compared. Results: The distribution frequency of CYP2C19 gene EM type, IM type and PM type in children were respectively 39. 13%, 42. 75% and 18. 12%. The total effective rate and Hp eradication rate of IM group and PM group were higher than those of EM group (P< 0. 05), and there was no statistically significant difference in the total effective rate and Hp eradication rate between IM group and PM group (P>0. 05). The total incidences of adverse drug reactions in EM group and IM group were lower than those in PM group (P<0. 05), and there was no statistical difference in the total incidences of adverse drug reactions between EM group and IM group (P>0. 05). Conclusion: There are differences in the efficacy and adverse drug reactions of Hp infected children with different CYP2C19 gene phenotypes after bismuth quadruple therapy. Both IM type and PM type children have significant efficacy, while EM type children have poor efficacy, PM type children are prone to adverse drug reactions.