摘要
幽门螺杆菌(Helicobacter pylori,Hp)是一种微需氧型革兰氏阴性菌,定植于人类的胃黏膜,是胃黏膜疾病发生的重要致病因素之一。临床上常见难治性Hp感染患者,难治性Hp感染的发生与Hp耐药基因以及患者肝药酶系统基因型密切相关。本文系统、全面地介绍了常见的Hp耐药基因以及患者CYP2C19基因多态性对Hp感染治疗效果的影响,通过梳理相关文献,简述了常用抗生素的耐药机制。并介绍在甲硝唑等高耐药地区,高剂量二联疗法等新型方案可能是更加有效的Hp根除治疗方案,更能提高Hp根除率。本文为我国难治性Hp感染患者治疗方案制定和实施提供一定的参考,并为难治性Hp感染耐药机制的深入研究提供借鉴。
Helicobacter pylori(Hp)is a microaerobic gram-negative bacterium that colonizes the human gastric mucosa and is one of the important pathogenic factors in the occurrence of gastric mucosal diseases.In clinical patients with refractory Hp infection,the occurrence of refractory Hp infection is closely related to the Hp resistance gene and the genotype of the liver drug enzyme system.This paper systematically and comprehensively introduces the effect of common Hp resistance genes and patient CYP2C19 gene polymorphism on the treatment effect of Hp infection.By combing the relevant literature,we briefly describe the resistance mechanism of commonly used antibiotics.It also introduces that in high-resistant areas such as metronidazole,new programs such as high-dose combination therapy may be more effective Hp eradication treatment programs and improve the Hp eradication rate.This paper provides some reference for the formulation and implementation of treatment programs for refractory Hp infection patients in China,and provides references for an in-depth study on the mechanism of drug resistance in refractory Hp infection.
作者
苏意
郑惠玲
于伟
石岩岩
Su Yi;Zheng Huiling;Yu Wei;Shi Yanyan(Clinical Epidemiology Research Center,Peking University Third Hospital,Beijing 100091,China;Peking University Health Science Center,Beijing 100091,China;Department of Gastroenterology,Peking University Third Hospital,Beijing 100091,China;Department of Gastroenterology,Affiliated Hospital of Jining Medical College,Jining 272001,Shandong,China)
出处
《中国医学前沿杂志（电子版）》
CSCD
北大核心
2024年第12期55-61,共7页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基金
北京市自然科学基金资助项目(J230002)。
