（此处英文文本似乎不完整，“of”后面缺少具体内容）关于儿童根除治疗的毒力基因型的影响。

The effect of virulence genotypes of on eradication therapy in children.

作者信息

Zhang Shuang-Hong, Zhu Xuan, Li Bi-Min, Li Hong

机构信息

Department of Gastroenterology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, China.

Central Laboratory, Children's Hospital of Jiangxi, Nanchang, Jiangxi Province, China.

出版信息

Saudi J Gastroenterol. 2018 Jul-Aug;24(4):249-254. doi: 10.4103/sjg.SJG_579_17.

DOI:10.4103/sjg.SJG_579_17

PMID:29652033

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6080151/

Abstract

BACKGROUND/AIM: It is important to eradicate Helicobacter pylori at an early stage in patients during childhood to potentially prevent the development of H. pylori-related diseases. Studies have demonstrated that the virulence genotype of H. pylori influences the efficacy of eradication therapy. The efficacy of triple therapy has decreased significantly, which has seriously affected the clinical outcome of children with H. pylori infection. In this study we aimed to investigate the influence of virulence genotypes of H. pylori on triple eradication therapy in children.

PATIENTS AND METHODS

H. pylori strains were isolated from the gastric antrum mucosa in children with upper gastrointestinal symptoms. Polymerase chain reaction (PCR) was conducted to determine the H. pylori cagA, vacA, and iceA genotypes. All patients with H. pylori infection were administered 14-day triple therapy. After drug withdrawal for at least 4 weeks, the C-urea breath test (C-UBT) was used to observe the therapeutic effect of H. pylori eradication. The eradication rates were evaluated by intention-to-treat (ITT) and per-protocol (PP) analyses.

RESULTS

A total of 107 patients were enrolled in this study. Nine patients were lost to follow-up, and 98 patients were administered eradication therapy. Based on ITT and PP analyses, the H. pylori eradication rate was 64.5% (69/107) and 70.4% (69/98), respectively. Among the successful eradication groups, the cagA-positive, vacA s1a, vacA s1c, vacA m1, vacA m2, iceA 1, and iceA 2 genes were identified in 72.8%, 68.1%, 76.9%, 60.0%, 74.6%, 71.8%, and 75.0% of strains, respectively. Of the unsuccessful eradication groups, the cagA-positive, vacA s1a, vacA s1c, vacA m1, vacA m2, iceA 1, and iceA 2 genes were identified in 27.2%, 31.9%, 23.1%, 40.0%, 25.4%, 28.2%, and 25.0% of strains, respectively. No statistically significant differences were noted in the detection rate of the H. pylori genotypes between the H. pylori successful and unsuccessful eradication groups (P > 0.05).

CONCLUSIONS

The cagA, vacA, and iceA genotypes of H. pylori are not associated with the efficacy of omeprazole-based triple therapy on the eradication of H. pylori infection in children.

摘要

背景/目的：在儿童期尽早根除幽门螺杆菌对于预防幽门螺杆菌相关疾病的发生具有重要意义。研究表明，幽门螺杆菌的毒力基因型会影响根除治疗的效果。三联疗法的疗效已显著下降，这严重影响了幽门螺杆菌感染儿童的临床治疗结果。本研究旨在探讨幽门螺杆菌毒力基因型对儿童三联根除治疗的影响。

患者与方法

从有上消化道症状的儿童胃窦黏膜中分离幽门螺杆菌菌株。采用聚合酶链反应（PCR）检测幽门螺杆菌的cagA、vacA和iceA基因型。所有幽门螺杆菌感染患者均接受为期14天的三联疗法治疗。停药至少4周后，采用碳-尿素呼气试验（C-UBT）观察幽门螺杆菌的根除治疗效果。通过意向性分析（ITT）和符合方案分析（PP）评估根除率。

结果

本研究共纳入107例患者。9例失访，98例接受根除治疗。基于ITT和PP分析，幽门螺杆菌根除率分别为64.5%（69/107）和70.4%（69/98）。在成功根除组中，cagA阳性、vacA s1a、vacA s1c、vacA m1、vacA m2、iceA 1和iceA 2基因分别在72.8%、68.1%、76.9%、60.0%、74.6%、71.8%和75.0%的菌株中被检测到。在根除失败组中，cagA阳性、vacA s1a、vacA s1c、vacA m1、vacA m2、iceA 1和iceA 2基因分别在27.2%、31.9%、23.1%、40.0%、25.4%、28.2%和25.0%的菌株中被检测到。幽门螺杆菌成功根除组与根除失败组之间幽门螺杆菌基因型的检测率无统计学显著差异（P>0.05）。