Objective To explore the clinical effect of individualized omeprazole quadruple therapy for helico-bacter pylori positive chronic gastritis under guidance of cytochrome P450 2C19 genotyping. Methods By DNA mi-croarray method,100 cases of extensive metabolizer patients and 100 cases of intermediate metabolizers with Hp posi-tive chronic gastritis were selected and divided into observation group and control group,50 cases in each group,respec-tively. All of the two control groups received quadruple therapy as "omeprazole 20 mg bid,amoxicillin 1. 0 g bid,clar-ithromycin 0.5 g bid and bismuth potassium citrate 220 mg bid". The observation group of EM received therapy as"omeprazole 60 mg bid,amoxicillin 1. 0 g bid,clarithromycin 0.5 g bid and bismuth potassium citrate 220 mg bid". The observation group of IM received therapy as "omeprazole 40 mg bid,amoxicillin 1. 0 g bid,clarithromycin 0.5 g bid and bismuth potassium citrate 220 mg bid". All patients were treated for 2 weeks,and at least 4 weeks after the end of treatment,the improvement of gastritis symptoms,clinical efficacy,Hp eradication rate and adverse reactions were compared between the two different groups. Results In the observation group of EM patients, the total efficiency was 96%,Hp eradication rate was 90%,but those of the control group were 48% and 44% (P0.05),but the total efficiency and Hp eradication rate of IM control group were significantly higher than those of EM control group(P0.05),EM型与IM型的对照组间比较,IM型的总有效率和Hp根除率皆明显高于EM型(P<0.01或P<0.05). 结论 CYP2C19基因分型可以为个体化抗Hp治疗提供参考,由此制定的PPI个体化给药方案,可以更有效地根除Hp及提高治疗慢性胃炎的疗效,值得临床推荐.
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