丽水地区幽门螺旋杆菌感染现状及治疗对策分析  

Helicobacter pylori infection status and treatment strategies in Lishui

作　　者：戴木根[1] 杨上文[1] 刘思宇[1] 傅丽霞[1] 汪剑波[1] 叶斌[1] DAI Mu-gen;YANG Shang-wen;LIU Si-yu;FU Li-xia;WANG Jian-bo;YE Bin(Department of Gastroenterology,Lishui Municipal Central Hospital,Lishui,Zhejiang 323000,China)

机构地区：[1]丽水市中心医院消化内科

出　　处：《中国卫生检验杂志》2019年第22期2751-2753,2756,共4页Chinese Journal of Health Laboratory Technology

基　　金：浙江省中医药基金资助项目(2015ZA226);丽水市高层次人才资助项目(2017RC22)

摘　　要：目的分析丽水地区幽门螺旋杆菌感染情况及其药敏谱,为本地幽门螺旋杆菌根除用药方案提供参考依据。方法回顾性分析2013年1月-2017年12月由于上消化道不适进行胃镜检查的16 806例患者,经14C呼气实验检测幽门螺旋杆菌感染者,行胃镜检查时,取胃黏膜活检培养幽门螺旋杆菌菌株。结果 16 806例患者中,幽门螺旋杆菌阳性株5 882例,阳性率34.99%。2013年-2017年本院幽门螺旋杆菌检测阳性率呈逐年上升趋势(χ^2趋势=14.707,P<0.05);不同年龄段幽门螺旋杆菌感染分布差异有统计学意义(χ^2=130.11,P<0.05)。5 882例幽门螺旋杆菌阳性株药敏实验显示幽门螺旋杆菌对甲硝唑耐药率最高、其次为左氧氟沙星和克拉霉素。结论本地区幽门螺旋杆菌感染主要分布在50岁以上人群,感染率逐年上升并且趋向年轻化,对青壮年幽门螺旋杆菌感染要给予高度重视。幽门螺旋杆菌感染者,不能仅当胃肠消化道疾病治疗,应当做感染性疾病,根据药敏试验结果治疗,可提高根除率,降低耐药率。Objective To investigate the distribution of Helicobacter pylori and drug resistance in the people of Lishui,so as to provide references for the treatment of Helicobacter pylori.Methods To retrospectively analyze 16806 patients undergoing gastroscopy due to upper gastrointestinal discomfort between January 2013 and December 2017,after 14C blowing test to detect whether there is Helicobacter pylori infection.For 14C positive patients,at the time of gastroscopy,gastric mucosa was taken for HP culture.Results 5882 cases were positive for Helicobacter pylori of the 16806 patients,with the positive rate of 34.99%.The positive rate of Helicobacter pylori showed increasing trend from 2013 to 2017(χ^2Trend=701,P<0.05);The results showed that the differences of age were statistically significant(χ^2=130.11,P<0.05).The drug resistance rate was the highest to metronidazole,followed by clarithromycin and levofloxacin.Conclusion Helicobacter pylori infection in the region is mainly distributed in the over 50 age group,and because the incidence of gastric cancer is young,more attention should be paid to Helicobacter pylori infection in young adults.Helicobacter pylori infection shouldn't be regarded as gastrointestinal disease but an infectious disease.According to drug sensitivity test results,the eradication rate can be improved and the drug resistance rate can be reduced.

关 键 词：幽门螺旋杆菌 感染 耐药性 

分 类 号：R446.5[医药卫生—诊断学]