炎症性肠病患者幽门螺杆菌感染情况及耐药性分析  

Analysis of Helicobacter pylori infection and drug resistance in patients with inflammatory bowel disease

作　　者：庄少华[1] 付金金 饶君 ZHUANG Shao-hua;FU Jin-jin;RAO Jun(Changzhou Second People's Hospital Affiliated to Nanjing Medical University,Changzhou,Jiangsu 213000,China)

机构地区：[1]南京医科大学附属常州市第二人民医院消化内科,江苏常州213000

出　　处：《中华医院感染学杂志》2020年第7期1016-1020,共5页Chinese Journal of Nosocomiology

摘　　要：目的分析炎症性肠病患者幽门螺杆菌感染情况与耐药性,为未来炎症性肠炎的诊治提供参考。方法选择南京医科大学附属常州市第二人民医院2017年2月-2019年2月胃肠外科或消化内科就诊治疗的初诊炎症性肠病患者120例,将120例炎症性肠病患者中86例溃疡性结肠炎纳为溃疡性结肠炎组,34例克罗恩病者纳为克罗恩病组,全部患者均接受胃肠镜检查及病理检查,抽取同期在医院接受常规体检的健康人群50名作为对照组,抽取入组者外周静脉血进行血培养,并对血培养结果为阳性者进行药敏试验,观察120例炎症性肠病患者幽门螺杆菌感染情况,对比三组入组者幽门螺杆菌感染率,分析并观察炎症性肠病患者幽门螺杆菌感染耐药情况,以年作为单位,对比2017年2月-2018年1月与2018年2月-2019年2月耐药率。结果120例患者中幽门螺杆菌感染共47例,感染率为39.17%,低于对照组的60.00%,差异有统计学意义(P<0.05);炎症性肠病幽门螺杆菌感染者对甲硝唑、克拉霉素、左氧氟沙星、莫西沙星均有不同程度耐药,但无完全耐药者;对阿莫西林、四环素、利福平、庆大霉素敏感性较高;2018年2月-2019年2月炎症性肠病患者幽门螺杆菌感染对克拉霉素、左氧氟沙星、莫西沙星的耐药率均较2017年2月-2018年1月升高,差异有统计学意义(P<0.05)。结论幽门螺杆菌感染可能是炎症性肠病发病的保护性因素,与疾病表型特征无相关性,菌株对常用抗菌药物的耐药率呈逐年升高趋势,这也是导致幽门螺杆菌根除率降低的主要原因,应引起临床重视。OBJECTIVE To analyze the Helicobacter pylori(Hp)infection and drug resistance in patients with inflammatory bowel disease,and to provide reference for the diagnosis and treatment of inflammatory bowel disease.METHODS A total of 120 patients with newly diagnosed inflammatory bowel disease in the gastrointestinal surgery or gastroenterology department of affiliated Changzhou second people’s hospital of Nanjing Medical University from Feb.2017 to Feb.2019 were enrolled.Eighty-six patients with ulcerative colitis were included in the ulcerative colitis group,and 34 patients with Crohn’s disease were in the Crohn’s disease group.All patients underwent gastrointestinal endoscopy and pathological examination.Fifty healthy people during physical examination in the hospital in the same period were selected as the control group.The peripheral venous blood of all subjects was taken for the blood culture.Samples with positive blood culture results were performed on the drug sensitivity test further.The Hp infection was observed in 120 patients with inflammatory bowel disease.The rate of Hp infection in the three groups was compared,and the drug resistance of Hp in patients with inflammatory bowel disease was analyzed.Taking the year as the variable,the drug resistance rate between Feb.2017 to Jan.2018 and Feb.2018 to Feb.2019 was compared.RESULTS Among 120 patients,there were 47 cases of Hp infection,and the infection rate was 39.17%,which was significantly lower than that in the control group of 60.00%(P<0.05).Hp in the patients with inflammatory bowel disease had different degrees of resistance to metronidazole,clarithromycin,levofloxacin and moxifloxacin,but no complete drug resistance.It had higher sensitivity of Hp to amoxicillin,tetracycline,rifampicin and gentamicin.The drug resistance rate of Hp to clarithromycin,levofloxacin and moxifloxacin in patients with inflammatory bowel disease from Feb.2018 to Feb.2019 was significantly higher than that from Feb.2017 to Jan.2018(P<0.05).CONCLUSION Hp infection may be t

关 键 词：炎症性肠病 幽门螺杆菌 感染情况 耐药性 

分 类 号：R574[医药卫生—消化系统]