抗生素耐藥基因突變與兒童幽門螺桿菌感染治療效果關系的研究

陳彭亮 劉旻 李楨 鄒姒妮 張勇

[摘要] 目的 分析克拉霉素、甲硝唑、阿莫西林等耐藥基因突變對幽門螺桿菌（Hp）感染患兒治療根除情況的影響。 方法 選取東莞市婦幼保健院（以下簡稱“我院”）2019年12月至2021年1月確診為Hp感染患兒76例，所有患兒均接受14 d標準三聯(lián)療法進行治療，測定Hp分離菌株對克拉霉素、甲硝唑及阿莫西林耐藥基因的突變情況，并分析其對抗幽門螺桿菌感染治療的影響。 結果 Hp感染患兒根除情況：顯效42例（55.3%），有效18例（23.6%），總有效率為78.9%;無效16例（21.1%）;Hp感染患兒根除治療療效的性別差異：男性患兒中顯效21例（56.8%），有效6例（16.2%），無效10例（27.0%）;女性患兒中顯效21例（53.8%），有效12例（30.8%），無效6例（15.4%），Hp感染患兒的治療療效在性別上比較，差異無統(tǒng)計學意義（P>0.05）;抗生素耐藥基因突變對Hp感染根除治療療效的影響：克拉霉素、甲硝唑耐藥基因突變對Hp感染患兒治療療效的影響比較，差異無統(tǒng)計學意義（P>0.05），阿莫西林耐藥基因突變對Hp感染患兒治療療效的影響比較，差異有統(tǒng)計學意義（P<0.05）。 結論 該地區(qū)治療Hp感染患兒可優(yōu)先考慮阿莫西林。

[關鍵詞] 幽門螺桿菌;阿莫西林;甲硝唑;克拉霉素;標準三聯(lián)療法

[中圖分類號] R725.1;R515? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1673-9701（2021）24-0014-04

Study on relationship between antibiotic resistance gene mutation and therapeutic effect of Helicobacter pylori infection in children

CHEN Pengliang? ?LIU Min? ?LI Zhen? ?ZOU Sini? ?ZHANG Yong

Department of Pediatrics，Dongguan Maternal and Child Health Hospital in Guangdong Province，Dongguan? 523000，China

[Abstract] Objective? To analyze the effect of clarithromycin （CLA），metronidazole，amoxicillin and other drug-resistant gene mutations on the treatment and eradication of Helicobacter pylori （Hp） infection in children. Methods A total of 76 children with Hp infection who were diagnosed in Dongguan Maternal and Child Health Hospital （hereinafter referred to as "our hospital"） from December 2019 to January 2021 were selected. All the children were given 14-day standard triple therapy. The mutation of the resistance genes of Hp isolates to CLA，metronidazole and amoxicillin were determined，and its effect on the treatment of Helicobacter pylori infection was analyzed. Results The eradication of Hp infection in children： 42 patients were excellent，with an excellent rate of 55.3%; 18 patients were effective， with an effective rate of 23.6% and the total effective rate of 78.9%; 16 patients were ineffective，with an ineffective rate of 21.1%. The gender differences in the curative effect of eradication therapy in children with Hp infection： 21 patients （56.8%） were excellent，and 6 patients （16.2%） were effective， and 10 patients （27.0%） were ineffective in male children; 21 patients （53.8%） were excellent，and 12 patients （30.8%） were effective，and 6 patients （15.4%） were ineffective in female chidren; no statistically significant differences were observed in the treatment curative effect of the children with Hp infection （P>0.05）. Effects of antibiotic resistance gene mutation on the curative effect of Hp infection eradication： no statistically significant differences were observed in the effects of CLA and metronidazole resistance gene mutations on the curative effect of children with Hp infection （P>0.05）， and a statistically significant different was observed in the curative effect of amoxicillin resistance gene mutation on the curative effect of children with Hp infection （P<0.05）. Conclusion Amoxicillin may be a priority in the treatment of children with HP infection in this region.