幽门螺旋杆菌清除治疗中甲硝唑、克拉霉素、阿莫西林的耐药性
A Study on the Drug Resistance to Metronidazol, Clarithromycin and Amoxicillin in the Scavenging Treatment of Helicobacter Pylori
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摘要: 目的 探究幽门螺旋杆菌 (H.pylori) 对不同种抗菌药物耐药问题的研究.方法 选取云南省昆明市第一人民医院2015年8月至2017年4月接诊出现消化道症状且经胃镜检查确诊幽门螺旋杆菌感染的240例患者为研究对象, 按照临床给药不同分为A、B、C 3组, A组80例患者给予 (埃索美拉唑+甲硝唑+左氧氟沙星) 治疗, B组80例患者给予 (埃索美拉唑+克拉霉素+左氧氟沙星) 治疗, C组80例患者给予 (埃索美拉唑+阿莫西林+左氧氟沙星) 治疗, 3组患者治疗10 d后通过胃镜从患者胃窦取2块胃粘膜组织, 进行幽门螺旋杆菌培养及E-test测试, 观察幽门螺旋杆菌感染个体对不同种抗菌药物的耐药性、临床治疗效果以及不良反应发生情况.结果 A组甲硝唑耐药率为51.25% (54/80) , 明显高于B组、C组, C组临床治疗总有效率为93.50%, 明显高于B组与A组, C组不良反应发生率为3.75%, 明显低于B组、A组, 各项数据差异有统计学意义 (P<0.05) .结论 清除幽门螺旋杆菌治疗中, 甲硝唑耐药性较高, 阿莫西林耐药性最低.Abstract: Objective To explore the study of the resistance of Helicobacter pylori (H.pylori) to different kinds of antibiotics. Me thods From August 2015 to April 2017, a total number of 240 patients with gastrointestinal symptoms examined by gastroscopy were diagnosed with Helicobacter pylori infection and selected in the First People's Hospital. According to the clinical medication, participants were divided into group A, B, and C. Each group contained 80 patients and received specific treatments: group A received esomeprazole + metronidazole+ levofloxacin treatment, group B received esomeprazole + clindamycin + levofloxacin treatment and group C received esomeprazole + active forest + levofloxacin. Ten days after the treatment, two pieces of gastric mucosa were removed from patients with gastric antrum by gastroscope. Spiral bacillus culture and E-test pylori test were performed to observe Helicobacter pylori resistance to different kinds of antimicrobial drugs, drugs' clinical effect and adverse reaction. Re s ults Resistance rate of metronidazole in group A was 51.25% (41/80) , significantly higher than that of group B and C; Group C's total effective rate was 93.50%, significantly higher than 81.25% in group B and48.75% in group A; Group C's incidence of adverse reactions was 3.75%, significantly lower than group B (10%) and group A (16.25%) . The difference was significant (P<0.05) . Conclus ion Helicobacter pylori infection is highly resistant to metronidazole, and the resistance of clarithromycin and amoxicillin also exists. In the treatment of Helicobacter pylori, amoxicillin shows the lowest resistance rate.
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Key words:
- Helicobacter pylori /
- Drug resistance /
- Sensitivity /
- Metronidazole /
- Clarithromycin /
- Antibacterial drug
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