2357例幽门螺杆菌感染及抗菌素耐药分析  

Epidemiological study on the infection and drug-resistance of Helicobacter pylori in gastropathic patients in Hangzhou District

作　　者：黄频[1] 楼望林[1] 杨更发[2] 杨宁敏[2] 

机构地区：[1]杭州市萧山区第一人民医院,杭州311201 [2]杭州致远医学检验所,杭州310009

出　　处：《中国新药杂志》2007年第13期1057-1059,1064,共4页Chinese Journal of New Drugs

摘　　要：目的：检测2357例上消化道疾病患者幽门螺杆菌（Helicobacter pylori，Hp）感染情况及其药物敏感性。方法：对患者胃黏膜组织进行增菌、分离培养、菌落涂片镜检、鉴定；Hp呈阳性者，采用纸片琼脂扩散法（K—B法）进行药物敏感性检测。结果：Hp阳性945例（40．09％）。胃癌、胃炎、消化性溃疡分别为70．27％（26／37），44．40％（737／1660），36．93％（154／417）；胃癌与胃炎、溃疡之间有显著性统计学差异（P〈0．01），胃炎与溃疡之间有明显差异（P〈0．01）。男女性别总感染率分别为59．81％和57．81％，男女性别问差异无显著性统计学差异（P〉0．05），45～55岁为Hp感染多发年龄段。药物敏感试验左氧氟沙星全部敏感；克拉霉素、庆大霉素和痢特灵3种药物的敏感率均在81．90％以上；甲硝唑的耐药率是98．10％（927／945），阿莫西林的耐药率是70．48％（666／945）；且存在多重耐药。结论：Hp是胃癌发生的重要因素，同时也是胃炎和溃疡发病因素。45～55岁之间属于Hp高感染阶段。在治疗时应注意Hp感染菌株对甲硝唑、阿莫西林和克拉霉素等药物耐药。Objective： To investigate the infection and drug-resistance of Helicobacter pylori in gastropathic patients with gastritis, gastric ulcer and gastric cancer in Hangzhou District. Methods： Bacteria were separated and cultured from the patients＇ gastric mucosa tissue. Suspected bacteria clones were smeared, stained and microscopic examined, and biochemistically tested for H. pylori identification; the drug-sensitivity tests were determined by K-B methods. Results： 2 357 specimens of patients＇ gastric mucosa tissue were examined in Hangzhou District. 954 H. pylori were identified. The positive ratio is 40. 09% （945/2 375）. It was shown that the H. pylori positive ratio in gastric cancer was 70. 27% （26/37）, gastritis was 44. 40% （ 737/1 660 ）, ulcer 36. 93 % （ 154/417 ）, others 10. 00% - 12. 31%. The incidence of Hp was significantly higher in gastric patients. The incidence of gastric cancer was significantly higher（ P 〈 0.01 ） than others. The incidence of gastritis was significantly higher（ P 〈 0.01 ） in gastric ulcer, whereas the incidence of male was no significantly different in female, and the positive ratio was 59.81% and 57.81%. Drug sensitivity test were performed on the 945 H. pylori, the results indicated that the H. pylori were sensitive to levofloxacinl00% （945/945） , kalamycin, gentamicin and furazolidone were above 81.90% , whereas the drug resistance ratio to metronidazole was 98.10% （927/945） , the drug resistance ratio to amoxicillin was 70.48% （666/945）and kalamycin was 18.10% （171/945）, the drug resistance ratio to kalamycin and amoxicillin was 16.72% （158/945） , the drug resistance ratio to kalamycin, metronidazole and amoxicillin was 16.72% （ 158/945 ） , and others were 0.53% - 5.08%. Conclusion：The Hp is rather serious factor in gastric cancer, and serious factor in gastritis or gastric ulcer, too. The Hp has pilosity stage at 45 - 55 years regardless of male or female. The doctor need to take notice of drug-resistance or more of

关 键 词：幽门螺杆菌 感染 耐药性 

分 类 号：R573.1[医药卫生—消化系统] R978.1[医药卫生—内科学]