幽门螺杆菌微生物学特征及其与慢性萎缩性胃炎的相关性  

Correlation between microbiological characteristics of Helicobacter pylori and chronic atrophic gastritis

作　　者：李玉梅[1] 龙小平[1] 毛晓雪 胡小英 辜程鸿 LI Yumei;LONG Xiaoping;MAO Xiaoxue;HU Xiaoying;GU Chenghong(Department of Clinical Laboratory,the Fourth People's Hospital of Zigong City,Zigong 643000,Sichuan,China)

机构地区：[1]自贡市第四人民医院检验科,四川自贡643000

出　　处：《检验医学》2024年第5期497-503,共7页Laboratory Medicine

摘　　要：目的探讨幽门螺杆菌(Hp)微生物学特征及其与慢性萎缩性胃炎(CAG)的关系。方法回顾性分析2020年11月—2022年11月自贡市第四人民医院300例慢性胃炎(CG)伴Hp感染患者临床资料,根据是否发生胃黏膜萎缩分为未萎缩组(136例)和萎缩组(164例)。分析2组患者临床特征、分离的Hp菌株微生物学特征和对常用抗菌药物的耐药性。采用Logistic回归分析评价胃黏膜萎缩的影响因素。构建贝叶斯网络预测模型,采用受试工作者特征(ROC)曲线和校准曲线对预测模型的区分度和准确度进行评价。结果萎缩组饮食不规律、有胃肠道疾病家族史、食用腌制品所占比例高于未萎缩组(P<0.05)。分离自萎缩组患者的Hp血清型、毒力基因和Ⅰ型菌株均高于未萎缩组(P<0.05)。分离自萎缩组患者的Hp对阿莫西林、甲硝唑和左氧氟沙星的耐药率均高于未萎缩组(P<0.05)。Logistic回归分析结果显示,饮食不规律、有胃肠道疾病家族史、食用腌制品、携带CagA抗体和cagA毒力基因、Ⅰ型菌株,以及阿莫西林、甲硝唑、左氧氟沙星耐药是胃黏膜萎缩的危险因素(P<0.05)。ROC曲线分析结果显示,贝叶斯网络预测模型具有良好的区分度和准确度。结论Hp菌株微生物学特征与CAG密切相关。Objective To investigate the correlation between the microbiological characteristics of Helicobacter pylori(Hp)and chronic atrophic gastritis(CAG).Methods The clinical data of 300 patients with chronic gastritis(CG)complicated with Hp infection diagnosed in the Fourth People's Hospital of Zigong City from November 2020 to November 2022 were analyzed retrospectively.The patients were classified into 2 groups according to whether gastric mucosal atrophy occurred,which included non-atrophy group(136 cases)and atrophy group(164 cases).The clinical characteristics,microbiological characteristics of Hp isolates and drug resistance to common antibiotics were compared between the 2 groups.Logistic regression analysis was used to evaluate the influencing factors of gastric mucosal atrophy.The Bayesian network prediction model was constructed,and the differentiation and accuracy of the prediction model were evaluated by receiver operating characteristic(ROC)curve and calibration curve.Results Irregular diet,family history of gastrointestinal diseases,consumption of pickled products in atrophy group were higher than those in non-atrophy group(P<0.05).Hp serotype and virulence gene in atrophy group were higher than those in non-atrophy group(P<0.05).The drug resistance of Hp in atrophy group to amoxicillin,metronidazole and levofloxacin was higher than that in non-atrophy group(P<0.05).Irregular diet,family history of gastrointestinal diseases,consumption of pickled products,carrying CagA antibody and cagA virulence gene,typeⅠisolates and drug resistance to amoxicillin,metronidazole and levofloxacin were risk factors for gastric mucosal atrophy(P<0.05).The Bayesian network prediction model had good differentiation and accuracy.Conclusions There is a correlation between the microbiological characteristics of Hp isolates and CAG.

关 键 词：幽门螺杆菌 慢性萎缩性胃炎 微生物学特征 

分 类 号：R378.99[医药卫生—病原生物学]