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目的探讨幽门螺杆菌(Hp)在我国南方温州地区人群中胃炎、胃溃疡、胃癌等感染分布情况及其耐药性研究.方法对患者胃粘膜组织进行增菌,分离培养,挑取菌落涂片镜检,并对其进行有关Hp生化反应鉴定;对鉴定Hp呈阳性者,采用纸片琼脂扩散法(简称K-B法)进行药物敏感性检测;对检测结果采用X~2检验分析.结果从该地区2357例胃病患者胃粘膜组织标本中检出幽门螺杆菌945株,其阳性率是40.00%(945/2357)。其中胃癌患者Hp检出阳性率是71.00%(26/37)、胃炎患者Hp检出阳性率是44.00%(737/1660)、溃疡患者Hp检出阳性率是37.00%(154/417),其它消化道疾病的HP感染阳性率分别为10.00%～12.31%,胃癌较其它消化道疾病具有显著性差异(x~2值分别为9.78～51.63,p<0.01),胃炎与溃疡之间有明显差异(x~2=7.55,p<0.01).各年龄组人群Hp感染率分布分析.男女性别总感染率分别为59.81%和57.81%,Hp感染率男女性别间差异无显著性差异(x~2=1.41,p>0.05),在45～55岁之间属于该地区Hp感染多发年龄阶段。对945株阳性Hp菌株药物敏感性试验,左氧氟沙星全部敏感,克拉霉素、庆大霉素和痢特灵三种药物的敏感率均在81.90%以上;甲硝唑的耐药率是98.00%(927/945),阿莫仙的耐药率是71.00%(666/945),克拉霉素的耐药率是18.00%(171/945),阿莫仙和克拉霉素双重耐药率是17.00%(158/945),克拉霉素、阿莫仙和灭滴灵多重耐药率是17.00%(158/945),其它抗生素多重耐药率分别是0.53%～5.08%.结论Hp感染与胃部疾病有关联性.Hp是胃癌发生的重要因素,同时也是胃炎和溃疡发生因素,无论是男性还是女性在45～55岁之间属于Hp多发阶段.在治疗时应注意Hp感染菌株对灭滴灵、阿莫仙和克拉霉素等药物耐药性或多重耐药性,对于开展Hp感染和相关疾病的防治意义重大.
Objective To investigate the distribution and drug resistance of Helicobacter pylori (Hp) in the population of gastritis, gastric ulcer and gastric cancer in Wenzhou of southern China.Methods The gastric mucosa of patients were enriched, isolated and cultured, and the colony smear Microscopic examination, and its Hp biochemical response identification; Hp-positive for those who identified, using paper agar diffusion method (KB method) for drug susceptibility testing of the test results using X ~ 2 test results from the Helicobacter pylori 945 strains were detected in 2357 cases of stomach cancer in gastric area, the positive rate was 40.00% (945/2357). The positive rate of Hp in gastric cancer was 71.00% (26/37), the positive rate of Hp in gastritis was 44.00% (737/1660), the positive rate of Hp in ulcer was 37.00% (154/417) The positive rates of HP infection in gastrointestinal diseases were 10.00% ~ 12.31%, there was significant difference between gastric cancer and other digestive diseases (x ~ 2 values were 9.78 ~ 51.63, p <0.01), there was significant difference between gastritis and ulcer (x ~ 2 = 7.55, p <0.01) .Analysis of Hp infection rate in all age groups showed that the total infection rates of male and female were 59.81% and 57.81%, respectively, and there was no significant difference between male and female Hp infection rates = 1.41, p> 0.05), between 45 and 55 years of age belong to the region of multiple Hp infection age. The susceptibility tests of 945 positive Hp strains were all sensitive to levofloxacin, and the sensitivity rates of clarithromycin, gentamicin and furazolidone were over 81.90%. The metronidazole resistance rate was 98.00% 927/945), Amoxicillin resistance rate was 71.00% (666/945), clarithromycin resistance rate was 18.00% (171/945), Amoxicillin and clarithromycin double resistance rate was 17.00 % (158/945), the rate of multiple drug resistance of clarithromycin, amoxicillin and metribuzin was 17.00% (158/945), and the rates of multiple drug resistance of other antibiotics were 0.53% ~ 5.08% respectively.Conclusion Hp infection and gastric Department of disease associated.Hp is an important factor in the occurrence of gastric cancer, but also gastritis and ulcers, both men and women in the 45 to 55 years of age belongs to the Hp multiple stages in the treatment should pay attention to Hp infected strains on the droplet Ling, Amoxicill and clarithromycin and other drug resistance or multi-drug resistance, for the prevention and treatment of Hp infection and related diseases of great significance.