基于抗体分型的幽门螺杆菌四联疗法治疗效果观察  

Observation of therapeutic effect of quadruple therapy of Helicobacter pylori based on antibody typing

作　　者：毕胜飞 赵婧 马子豪 高学智 张辉 王仲玉 宋歌 BI Shengfei;ZHAO Jing;MA Zihao;GAO Xuezhi;ZHANG Hui;WANG Zhongyu;SONG Ge(Clinical Laboratory,Jiugang Hospital,Gansu Province,Jiayuguan 735100,China;不详)

机构地区：[1]酒钢医院检验科,甘肃省嘉峪关市735100 [2]酒钢医院重症医学科,甘肃省嘉峪关市735100 [3]酒钢医院消化科,甘肃省嘉峪关市735100

出　　处：《临床合理用药》2025年第1期13-16,20,共5页Chinese Journal of Clinical Rational Drug Use

基　　金：嘉峪关市科技计划项目(22-B13)。

摘　　要：目的基于幽门螺杆菌(Hp)抗体分型,观察Hp四联疗法的治疗效果。方法选取2023年1月—2024年3月就诊于酒钢医院消化内科门诊~(14)C尿素呼气试验阳性的Hp现症感染患者215例为病例组,依据Hp抗体分型分为Ⅰ型亚组146例和Ⅱ型亚组69例。另选取健康体检者122例为健康对照组。病例组采用四联疗法治疗,总疗程2周。治疗后4周,比较Ⅰ型亚组和Ⅱ型亚组~(14)C尿素呼气试验转阴率,治疗前后Ⅰ型亚组、Ⅱ型亚组与健康对照组的胃肠激素[胃泌素-17(G-17)、胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、胃蛋白酶原比值(PGR)]、炎性因子[白介素-6(IL-6)、超敏C反应蛋白(hs-CRP)]水平及不良反应。结果治疗后4周,Ⅰ型亚组~(14)C尿素呼气试验转阴率为80.82%(118/146),高于Ⅱ型亚组的72.46%(50/69),但差异无统计学意义(χ^(2)=1.916,P=0.166)。治疗前,Ⅰ型亚组和Ⅱ型亚组G-17、PGⅠ、PGⅡ、IL-6、hs-CRP水平高于健康对照组,PGR低于健康对照组,且Ⅰ型亚组G-17、PGⅠ、PGⅡ水平高于Ⅱ型亚组,PGR低于Ⅱ型亚组(P<0.01);治疗后4周,Ⅰ型亚组和Ⅱ型亚组G-17、PGⅠ、PGⅡ水平均降低,PGR均升高(P<0.05或P<0.01),但Ⅰ型亚组G-17、PGⅠ、PGⅡ水平和Ⅱ型亚组的PGⅡ水平仍高于健康对照组,Ⅰ型亚组的PGR仍低于健康对照组(P<0.05);Ⅱ型亚组的G-17、PGⅠ、PGR水平与健康对照组比较差异无统计学意义(P>0.05)。治疗前,Ⅰ型亚组和Ⅱ型亚组IL-6、hs-CRP水平高于健康对照组,且Ⅰ型亚组IL-6、hs-CRP水平高于Ⅱ型亚组(P<0.01);治疗后4周,Ⅰ型亚组和Ⅱ型亚组IL-6、hs-CRP水平低于治疗前,但高于健康对照组(P<0.01)。Ⅰ型亚组与Ⅱ型亚组不良反应总发生率比较差异无统计学意义(6.85%vs.5.80%,χ^(2)=0.085,P=0.770)。结论不同抗体分型Hp对胃黏膜的损害程度不同,Ⅰ型菌株对患者胃黏膜损害更大,四联疗法对Ⅰ型Hp感染和Ⅱ型Hp感染的治疗效果均较好,且Ⅰ型感染~(14)C�Objective Based on Helicobacter pylori(Hp)antibody typing,the therapeutic effect of Hp quadruple therapy was observed.Methods A total of 215 patients with Hp infection who were admitted to the Gastroenterology Department of Jiugang Hospital from January 2023 to March 2024 with positive 14 C urea breath test were selected as the case group,and were divided into typeⅠsubgroup(146 cases)and typeⅡsubgroup(69 cases)according to Hp antibody type.Another 122 healthy subjects were selected as healthy control group.The patients were treated with quadruple therapy for a total course of two weeks.Four weeks after treatment,the negative conversion rate of 14 C urea breath test was compared between typeⅠsubgroup and typeⅡsubgroup.The levels of gastrointestinal hormones(G-17,PGⅠ,PGⅡ,PGR),inflammatory factors(IL-6,hs-CRP)before and after treatment,and adverse reactions in subgroupsⅠ,Ⅱand healthy control group were compared.Results At four weeks after treatment,the negative conversion rate of 14 C urea breath test in typeⅠsubgroup was 80.82%(118/146),higher than 72.46%in typeⅡsubgroup(50/69),but the difference was not statistically significant(χ^(2)=1.916,P=0.166).Before treatment,the levels of G-17,PGⅠ,PGⅡ,IL-6 and hs-CRP in typeⅠand typeⅡsubgroups were higher than those in healthy control group,the PGR levels were lower than those in healthy control group,and the levels of G-17,PGⅠ,PGⅡin typeⅠsubgroup were higher than those in typeⅡsubgroup,and the PGR levels were lower than those in typeⅡsubgroup(P<0.01).Four weeks after treatment,the levels of G-17,PGⅠand PGⅡin typeⅠsubgroup and typeⅡsubgroup were decreased,and PGR were increased(P<0.05 or P<0.01),but the levels of G-17,PGⅠ,PGⅡin typeⅠsubgroup and PGⅡin typeⅡsubgroup were still higher than those in healthy control group,and the PGR in typeⅠsubgroup was still lower than that in healthy control group(P<0.05).There was no significant difference in G-17,PGⅠand PGR levels between typeⅡsubgroup and healthy control grou

关 键 词：幽门螺杆菌感染 抗体分型 四联疗法 胃肠激素 炎性因子 

分 类 号：R573[医药卫生—消化系统]