109例幽门螺杆菌培养阳性患者耐药情况及临床治疗分析

摘要

Objective To guide the selection of the Helicobacter pylori(Hp)eradication therapy drugs according to the results of drug resistance and drug sensitivity tests in 109 cases of Hp culture-positive patients.Methods Patients with positive rapid urease test un-derwent Hp culture,and the statistical analysis was conducted by age and sex according to the culture results.Susceptibility test was conducted in Hp positive patients,and resistance rate was further analyzed between the urban and rural residents.The results of suscep-tibility testing were used to guide the antibiotics selection for Hp eradication therapy,and the therapeutic effects of two groups were com-pared.Results A hundred and nine cases were Hp positive patients after bacterial culture.There were no significant differences in age,gender and disease distribution either in Hp positive or negative group (P>0.05).Susceptibility test results showed that drug re-sistance rates in metronidazole,frazolidone,tetracycline,amoxicillin,clarithromycin,gentamicin,levofloxacin were 7.70%,2.20%, 33.94%,10.09%,9.17%,2.75%and 2.75%,respectively.The drug resistance rates in urban and rural residents were 57.14%and 79.01%,respectively,and the results had statistical differences (P<0.05).In addition,there was significant difference in Hp eradica-tion rate between the Hp positive group (97.89%)and negative group (82.96%),and the Hp eradication rate in both group could satisfy the clinical requirement of not less than 80%.Conclusions Hp culture and sensitivity test can be considered as an effective way of analysis of Hp infection and drug resistance,and are beneficial to drug choice for Hp eradication therapy.%目的：针对109例幽门螺杆菌（Helicobacter pylori，Hp）培养阳性患者药敏试验结果及耐药情况分析，指导临床选择根除Hp治疗的药物。方法对快速尿素酶试验阳性的患者进行幽门螺杆菌的培养，将培养阳性和阴性的患者进行年龄和性别的统计学分析。同时对于培养阳性的菌株进行药敏试验，根据结果对城乡居民进行耐药率比较。根据药敏试验选择抗生素进行Hp根除治疗，对于培养阴性的患者根据阳性组药敏试验结果经验性的选择抗生素进行根除Hp治疗，将两组治疗结果进行统计学分析，判断根除治疗效果。结果109例患者培养出幽门螺杆菌，培养阳性组和阴性组在年龄组成、性别和疾病分布上相近（P＞0．05），药敏实验结果表明对甲硝唑、呋喃唑酮、四环素、阿莫西林、克拉霉素、庆大霉素、左氧氟沙星的耐药率分别为47．70％、42．20％、33．94％、10．09％、9．17％、2．75％及2．75％。其中，在城市居民中耐药率为57．14％，在乡镇居民中耐药率79．01％，，有显著差异（P ＜0．05）。培养阳性组Hp根除率达到97．89％，阴性组的根除率也达到了82．96％，两组对比有显著差异（P ＜0．05），但是均能达到根除率不低于80％的临床要求。结论 Hp的培养和药敏试验可作为幽门螺杆菌感染和耐药情况分析的有效方法，有利于指导临床进行根除Hp治疗的药物选择。