89例小儿幽门螺杆菌感染患者耐药基因的突变分析  

Mutation Analysis of Drug Resistance Gene in 89 Children with Helicobacter Pylori Infection

作　　者：邹姒妮[1] 马战英[1] 李桢[1] 陈剑雄 方沛安 ZOU Sini;MA Zhanying;LI Zhen;CHEN Jianxiong;FANG Peian(Dept.of PICU,Dongguan City Maternal and Children Health Hospital,Guangdong Dongguan 523000,China)

机构地区：[1]东莞市妇幼保健院PICU,广东东莞523000

出　　处：《中国医院用药评价与分析》2020年第9期1083-1085,共3页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：东莞市社会科技发展(一般)项目(No.201950715007793)。

摘　　要：目的:探讨东莞市妇幼保健院(以下简称"我院")89例小儿幽门螺杆菌(Helicobacter pylori,Hp)感染患者耐药基因的突变情况。方法:选取2017年1月至2019年6月我院收治的Hp感染患儿89例,所有患儿均接受以质子泵抑制剂为中心的三联方案,即奥美拉唑钠肠溶片+阿莫西林克拉维酸钾颗粒+克拉霉素片治疗,疗程为2周。经PCR扩增试剂测定Hp分离菌株对克拉霉素、阿莫西林克拉维酸钾的耐药情况,并分析不同药物的耐药基因突变情况,记录突变率。结果:共分离出Hp菌株89株,其对克拉霉素、阿莫西林克拉维酸钾的耐药率分别为17.98%(16株)、15.73%(14株)。男性、女性患儿的Hp对克拉霉素、阿莫西林克拉维酸钾的耐药率比较,差异无统计学意义(P>0.05)。克拉霉素突变位点A2142G、A2143G和T2182C的突变率分别为26.97%(24/89)、3.37%(3/89)和47.19%(42/89),以T2182C的突变率最高。阿莫西林克拉维酸钾突变位点C1667G、A1684G和A1777G的突变率分别为4.49%(4/89)、2.25%(2/89)和12.36%(11/89),以A1777G的突变率最高。耐药患儿的A2142G、A2143G基因突变率分别为91.67%(22/24)、100.00%(3/3),高于敏感患儿的8.33%(2/24)、0。结论:Hp对克拉霉素与阿莫西林克拉维酸钾的耐药率非常接近,其中耐药患儿的A2142G、A2143G基因突变率较敏感患儿更高。OBJECTIVE:To probe into the mutation of drug resistance gene in 89 children with Helicobacter pylori(Hp)infection in Dongguan City Maternal and Children Health Hospital(hereinafter referred to as"our hospital").METHODS:89 children with HP infection admitted into our hospital from Jan.2017 to Jun.2019 were selected.All the children were given triple therapy centered on PPI,namely Omeprazole sodium enteric-coated tablets+Amoxicillin clavulanate potassium granules+Clarithromycin tablets,the course of treatment was 2 weeks.The resistance of Hp isolated strains to clarithromycin and Amoxicillin clavulanate potassium was determined by PCR amplification reagents,the mutations of resistance genes of different drugs were analyzed,and the mutation rate was recorded.RESULTS:A total of 89 Hp strains were isolated,the resistance rates of clarithromycin and amoxicillin clavulanate potassium were respectively 17.98%(16 strains)and 15.73%(14 strains).There was no statistical significance in difference in drug resistance rates of clarithromycin and amoxicillin clavulanate potassium between boys and girls(P>0.05).The mutation rates of clarithromycin mutation sites A2142G,A2143G and T2182C were respectively 26.97%(24/89),3.37%(3/89)and47.19%(42/89),with T2182C having the highest mutation rate.The mutation rates of amoxicillinclavulanate potassium mutation sites C1667G,A1684G and A1777G were respectively 4.49%(4/89),2.25%(2/89)and 12.36%(11/89),with A1777G having the highest mutation rate.The mutation rates of A2142G and A2143G genes in children with drug resistance were respectively 91.67%(22/24)and 100.00%(3/3),which were higher than 8.33%(2/24)and 0 in sensitive children.CONCLUSIONS:The drug resistance rates of clarithromycin and amoxicillin clavulanate potassium are very close,and the mutation rates of A2142G and A2143G genes in children with drug resistant are higher than those in sensitive children.

关 键 词：幽门螺杆菌 耐药基因 克拉霉素 阿莫西林克拉维酸钾 雷贝拉唑 

分 类 号：R975[医药卫生—药品]