基于一次性胃部细胞无创采样器的幽门螺杆菌耐药基因检测及其临床应用研究  

Disposable non-invasive gastric specimen collection string-based genetic testing for Helicobacter pylori drug resistance and its clinical application

作　　者：翁梅婷 杨莉丽[1] 邹傲[1] 吴慧华[1] 郭海[1] 张燕燕[1] 李曦[1] 王俊萍[1] Weng Meiting;Yang Lili;Zou Ao;Wu Huihua;Guo Hai;Zhang Yanyan;Li Xi;Wang Junping(Department of Gastroenterology,Peking University Shenzhen Hospital,Guangdong Shenzhen 518036,China)

机构地区：[1]北京大学深圳医院消化内科,广东深圳518036

出　　处：《新发传染病电子杂志》2023年第5期36-40,共5页Electronic Journal of Emerging Infectious Diseases

基　　金：北京大学深圳医院临床研究面上项目基金资助(LCYJ2021014)。

摘　　要：目的基于一次性胃部细胞无创采样器采集胃液标本进行幽门螺杆菌耐药基因检测,指导幽门螺杆菌个体化治疗,探讨此技术的临床应用价值。方法选取2021年5月至2022年5月北京大学深圳医院收治的根治失败2次或以上的难治性幽门螺杆菌感染患者50例,使用一次性胃部细胞无创采样器采集胃液,通过荧光定量PCR法检测抗生素耐药基因,根据耐药结果给予患者制订基于铋剂四联根除治疗方案,疗程14d,治疗结束至少4周后复查尿素呼气试验,确定幽门螺杆菌是否被成功根除。结果在50例送检样本中,检测幽门螺杆菌阳性者为43例。43例个体化治疗患者根除成功41例,幽门螺杆菌感染根除率意向性分析为95.35%(95%CI为84.19%~99.43%),遵循方案分析为97.62%(95%CI为87.43%~99.94%),均显著优于标准铋剂四联疗法(P<0.001)。结论基于一次性胃部细胞无创采样器采集胃液标本进行幽门螺杆菌耐药基因检测技术指导的个体化治疗在顽固性幽门螺杆菌感染患者中取得比较理想的临床效果,具有较好的应用价值。Objective We explored the clinical application value of using disposable non-invasive gastric specimen collection string to collect patient gastric material followed by antibiotic resistance detection to facilitate susceptibility-guided Helicobacter pylori(H.pylori)eradication therapy.Method Fifty patients with refractory H.pylori infection who previously failed twice or more H.pylori eradication to Peking University Shenzhen Hospital from May 2021 to May 2022,therapies performed a disposable non-invasive gastric specimen collection string that involves swallowing and retrieval of a disposable string to obtain their gastric specimen for drug resistance detection via quantitative PCR.Based on the test results,patients were prescribed with susceptibility-guided bismuth-based quadruple eradication therapy for 14 days.A follow-up urea breath test was performed at least 4 weeks after the completion of treatment to confirm eradication.Result Of 50 recruited patients,43 were tested positive for H.pylori infection by the qPCR test and received individualized treatment.Successful H.pylori eradication was confirmed in 41 patients,with an eradication rate of 95.35%(95%CI 84.19%to 99.43%)in the intention-to-treat analysis and 97.62%(95%CI 87.43%to 99.94%)based on per-protocol analysis,which were significantly better than that of the conventional bismuth-based eradication therapy(P<0.001).Conclusion Based on disposable non-invasive gastric specimen collection string,the qPCR test has been shown to be clinically effective in guiding our use of personalized H.pylori eradication therapy for treating patients with antibiotic-resistant H.pylori infection.

关 键 词：幽门螺杆菌 一次性胃部细胞无创采样器 基因检测 耐药检测 个体化治疗 

分 类 号：R573[医药卫生—消化系统]