Lan Qiao-Li, Sun Hao-Yue, Ye Yi, Wang Ying, Liu Ya, Weng Xue-Jian
Department of Digestive System, Wenzhou People's Hospital, The Third Affiliated Hospital of Shanghai University, The Wenzhou Third Clinical College of Wenzhou Medical University, Wenzhou, 325000, People's Republic of China.
Infect Drug Resist. 2022 Apr 29;15:2339-2345. doi: 10.2147/IDR.S358464. eCollection 2022.
This study aimed to investigate related factors affecting the eradication rate of (Hp) by modified quadruple therapy.
Between September 2020 and March 2021, 341 patients who were diagnosed with Hp infection and whose infections were confirmed by gastroscopy, a histological examination, and a C13-UBT without culturing and antimicrobial susceptibility studies received a two-week anti-Hp treatment, a modified quadruple therapy, in our department. The result of C13-UBT was rechecked 4 weeks after the drug withdrawal, and the patients were divided into two groups-a success group and a failure group-according to the final breath result. The general clinical information and related laboratory indexes of each patient were collected, and the factors affecting the eradication rate were analyzed.
The total clinical eradication rate was 80.06% (273/341), and the failure rate was 19.94% (68/341), correspondingly. Univariate analysis identified statistically significant differences between the two groups in serum 25-hydroxyvitamin D levels, presence of oral diseases, positive cytotoxin-associated gene A (CagA), and medical compliance ( < 0.05). Meanwhile, the use of a proton pump inhibitor (PPIs) and antibiotics was statistically different ( < 0.05). Logistic regression analysis revealed that vitamin D level (<20 ng/mL) [OR = 98.56, 95% CI (29.01-334.83), < 0.001] and medical compliance [OR = 148.18, 95% CI (37.64-583.33), < 0.001] were independent effecting factors for eradication rate.
Serum 25-hydroxyvitamin D level lower than 20 ng/mL may affect the success of eradication of Hp and is an independent risk factor for eradication failure.
本研究旨在探讨改良四联疗法影响幽门螺杆菌(Hp)根除率的相关因素。
2020年9月至2021年3月期间,341例经胃镜检查、组织学检查及C13尿素呼气试验(C13-UBT)确诊为Hp感染但未进行培养及药敏研究的患者,在我科接受了为期两周的抗Hp治疗,即改良四联疗法。停药4周后复查C13-UBT结果,根据最终呼气结果将患者分为成功组和失败组。收集每位患者的一般临床资料及相关实验室指标,并分析影响根除率的因素。
临床总根除率为80.06%(273/341),失败率为19.94%(68/341)。单因素分析显示,两组在血清25-羟基维生素D水平、口腔疾病的存在、细胞毒素相关基因A(CagA)阳性及服药依从性方面存在统计学显著差异(P<0.05)。同时,质子泵抑制剂(PPIs)和抗生素的使用也存在统计学差异(P<0.05)。Logistic回归分析显示,维生素D水平(<20 ng/mL)[比值比(OR)=98.56,95%置信区间(CI)(29.01-334.83),P<0.001]和服药依从性[OR=148.18,95%CI(37.64-583.33),P<0.001]是根除率的独立影响因素。
血清25-羟基维生素D水平低于20 ng/mL可能影响Hp根除的成功率,是根除失败的独立危险因素。