Dai Na, Zhao Yu-Qin, Wu Wen-Juan, Shen Zheng-Lin, Xu Yan-Hua, Wu Xiao-Yang, Zhang Gui-Zhen, Wang Lan, Wang Qing-Hua
Department of Gastroenterology, The First People's Hospital of Kunshan, Kunshan, China.
Department of Pharmacy, The First People's Hospital of Kunshan, Kunshan, China.
Clin Transl Gastroenterol. 2025 Feb 1;16(2):e00804. doi: 10.14309/ctg.0000000000000804.
Helicobacter pylori (HP) infection is prevalent worldwide and contributes to various gastrointestinal diseases. Eradication therapy is crucial in managing HP infection, but antibiotic resistance has led to refractory cases, complicating treatment outcomes and increasing the risk of adverse events. This study aimed to evaluate the effectiveness of a multidisciplinary approach, termed HP Multidisciplinary Team (MDT) Clinic, in improving eradication rates and safety in patients with refractory HP infection.
Between November 2020 and November 2023, 153 patients with refractory HP infection were included, with 51 patients in the non-HP-MDT group and 102 patients in the HP-MDT group. The HP-MDT clinic provided personalized treatment plans, patient education, and follow-up. Genetic testing was conducted in selected cases to assess resistance patterns.
Patients attending the HP-MDT clinic showed significantly higher eradication rates compared with those in the non-HP-MDT group (80.39% vs 50.98%, P < 0.001). Logistic regression analysis confirmed that HP-MDT clinic attendance was independently associated with higher eradication rates (odds ratio: 4.43, 95% CI: 2.02 to 9.71, P < 0.001). Genetic testing revealed high rates of antibiotic resistance, particularly to clarithromycin (10/11, 90.91%) and metronidazole (11/11, 100%). Despite resistance, the HP-MDT approach achieved a high eradication rate of 92.31%. Adverse drug reactions occurred in 12.75% of patients in the HP-MDT group, predominantly mild gastrointestinal symptoms.
The HP-MDT clinic, integrating medical, pharmaceutical, and nursing expertise, significantly improved eradication rates and safety in patients with refractory HP infection. Personalized treatment plans, patient education, and genetic testing contributed to successful outcomes with minimal adverse events.
幽门螺杆菌（HP）感染在全球范围内普遍存在，并导致各种胃肠道疾病。根除治疗对于管理HP感染至关重要，但抗生素耐药性导致了难治性病例，使治疗结果复杂化并增加了不良事件的风险。本研究旨在评估一种多学科方法，即HP多学科团队（MDT）诊所，在提高难治性HP感染患者的根除率和安全性方面的有效性。
在2020年11月至2023年11月期间，纳入了153例难治性HP感染患者，非HP-MDT组51例，HP-MDT组102例。HP-MDT诊所提供个性化治疗方案、患者教育和随访。在选定病例中进行基因检测以评估耐药模式。
与非HP-MDT组相比，就诊于HP-MDT诊所的患者根除率显著更高（80.39%对50.98%，P<0.001）。逻辑回归分析证实，就诊于HP-MDT诊所与更高的根除率独立相关（优势比：4.43，95%置信区间：2.02至9.71，P<0.001）。基因检测显示抗生素耐药率很高，尤其是对克拉霉素（10/11，90.91%）和甲硝唑（11/11，100%）。尽管存在耐药性，HP-MDT方法仍实现了92.31%的高根除率。HP-MDT组12.75%的患者发生药物不良反应，主要为轻度胃肠道症状。
整合医学、药学和护理专业知识的HP-MDT诊所显著提高了难治性HP感染患者的根除率和安全性。个性化治疗方案、患者教育和基因检测有助于取得成功结果，不良事件最少。
