幽门螺杆菌血清抗体对埃索美拉唑四联疗法根除效果的影响研究  

Serum Antibodies of Helicobacter Pylori Affecting Eradication Efficacy of Esomeprazole Quadruple Therapy

作　　者：崔梅花[1,2] 杨友鹏 岳林[1,2] 傅怡[1,2] 乙国兴[1,2] 牟方宏[1,2] 杨桂彬[1,2] 朱红霞[1,2] 张秀丽[1,2] 

机构地区：[1]航天中心医院 [2]北京大学航天临床医学院消化科,北京市100049

出　　处：《中国全科医学》2013年第8期850-853,共4页Chinese General Practice

基　　金：首都特色临床医学应用发展项目(D101100050010045)

摘　　要：目的探讨幽门螺杆菌(H.pylori)血清抗体对埃索美拉唑(耐信)四联疗法根除效果的影响。方法选取2010年8月—2011年11月我院诊治的胃十二指肠疾病患者为研究对象,采用前瞻性研究方法,纳入符合条件的慢性胃炎及消化性溃疡患者107例。采用蛋白芯片检测患者血清H.pylori尿素酶(Ure)、细胞毒素相关蛋白(Ca-gA)、空泡毒素(VacA)、热休克蛋白60(Hsp60)、硝基还原酶(RdxA)的IgG抗体。采用埃索美拉唑四联疗法进行根除H.pylori治疗,疗程结束后4周采用13C-尿素呼气试验判断H.pylori根除效果。结果 H.pylori总体根除率为86.0%(92/107)。不同疾病类型〔消化性溃疡(92.7%)vs.慢性胃炎(78.8%)〕、抗CagA状态〔CagA阳性(90.7%)vs.CagA阴性(75.0%)〕患者H.pylori根除率比较,差异均有统计学意义(P<0.05);不同性别、年龄及抗VacA、抗Hsp60、抗RdxA状态患者H.pylori根除率比较,差异均无统计学意义(P>0.05)。多因素分析结果显示,疾病类型〔OR=0.162,95%CI(0.034,0.764),P=0.021〕、抗CagA状态〔OR=0.219,95%CI(0.057,0.837),P=0.026〕对Logistic回归方程的影响均有统计学意义。结论埃索美拉唑四联疗法根除H.pylori效果满意,疾病类型、抗CagA状态是影响H.pylori根除效果的独立影响因素。Objective To observe the influence of serum antibodies of Helicobacter pylori(H.pylori)on the eradication efficacy of esomeprazole quadruple therapy.Methods Patients with gastroduodenal diseases admitted from August 2010 to November 2011 were enrolled in this study and a total of 107 patients with chronic gastritis and peptic ulcer were consistent with the inclusive criteria.Protein chips were used to detect the antibody repertoire of serum H.pylori including IgG antibodies of urease(Ure),cytotoxin-associated protein(CagA),vacuolating cytotoxin(VacA),heat shock protein 60(Hsp60),nitroreductase(RdxA).Esomeprazole quadruple therapy was used to perform H.pylori eradication and 13C-breath test to judge the effect of H.pylori eradication 4 weeks after treatment.Results Overall H.pylori eradication rate was 86.0%(92/107).H.pylori eradication rate was higher in peptic ulcer patients than in chronic gastritis patients(92.7% vs.78.8%,P=0.039),and higher in anti-CagA-positive patients than in anti-CagA-negative group(90.7% vs.75.0%,P=0.033).There was no significant difference in H.pylori eradication rate between different patients of sex,age,anti-VacA,anti-Hsp60 or anti-RdxA(P>0.05).Multivariate analysis revealed that eradication effects were related with disease types(OR=0.162,95%CI(0.034,0.764),P=0.021)and anti-CagA status(OR=0.219,95%CI(0.057,0.837),P=0.026).Conclusion Esomeprazole quadruple therapy is with satisfaction in the eradication of H.pylori;Type of disease and anti-CagA status are independent factors affecting H.pylori eradication efficacy.

关 键 词：螺杆菌 幽门 抗体 影响因素 四联疗法 

分 类 号：R378.2[医药卫生—病原生物学]