Guan Jia-Lun, Xu Ting-Ting, Lin Ya, Mo Yan-Shuai, He Bi-Yu, Han Ying-Ying, Li Ji-Yan, Xia Su-Hong, Zhou Ya-Ni, Liao Jia-Zhi, Li Pei-Yuan
Division of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China.
Department of Gastroenterology, Wenchang People's Hospital, Wenchang, China.
Gut Pathog. 2025 Jan 30;17(1):7. doi: 10.1186/s13099-025-00682-8.
Helicobacter pylori (H. pylori) eradication regimens may have different effects on the gut microbiota. Few studies have analyzed the safety of high-dose dual therapy (HDDT) from a micro-ecological perspective. This study aimed to compare the impact of H. pylori eradication with HDDT and bismuth quadruple therapy (BQT) on gut microbiota.
H. Pylori-infected treatment-naive patients were recruited and screened from September 2023 to April 2024 and randomly assigned to the HDDT group (esomeprazole 20 mg, amoxicillin 750 mg, qid, 14 days) or BQT group (esomeprazole 20 mg, amoxicillin 1000 mg, clarithromycin 500 mg, and bismuth potassium citrate 600 mg, bid, 14 days). Fresh stool specimens were collected and stored before treatment and at week 2 and week 8 after treatment. The diversity and composition of the gut microbiota were compared and analyzed in both groups using 16 S rRNA gene sequencing.
Forty-nine H. pylori positive patients were enrolled and randomly assigned to either the HDDT (n = 24) or the BQT group (n = 25) group. Compared with baseline, alpha and beta diversities significantly changed at week 2 after receiving BQT and did not recover fully at week 8. However, in the HDDT group, the diversities at week 2 changed mildly without statistical significance, compared to baseline. Additionally, a greater number of species had alterations in their abundances in the BQT group compared to the HDDT group at week 2. However, the abundances of these species were restored to their previous levels at week 8 in both the HDDT and BQT groups.
Compared to BQT, HDDT exerted less impact on the diversity and composition of the gut microbiota.
ChiCTR2100053268.
幽门螺杆菌（H. pylori）根除方案可能对肠道微生物群有不同影响。很少有研究从微生态角度分析高剂量双联疗法（HDDT）的安全性。本研究旨在比较HDDT和铋剂四联疗法（BQT）根除幽门螺杆菌对肠道微生物群的影响。
招募2023年9月至2024年4月期间未接受过治疗的幽门螺杆菌感染患者并进行筛查，随机分为HDDT组（埃索美拉唑20mg，阿莫西林750mg，每日4次，共14天）或BQT组（埃索美拉唑20mg，阿莫西林1000mg，克拉霉素500mg，枸橼酸铋钾600mg，每日2次，共14天）。在治疗前、治疗后第2周和第8周收集并储存新鲜粪便标本。使用16S rRNA基因测序对两组肠道微生物群的多样性和组成进行比较和分析。
49例幽门螺杆菌阳性患者入组并随机分为HDDT组（n = 24）或BQT组（n = 25）。与基线相比，接受BQT治疗后第2周，α和β多样性显著变化，第8周未完全恢复。然而，在HDDT组中，与基线相比，第2周的多样性变化轻微，无统计学意义。此外，在第2周时，BQT组中丰度发生改变的物种数量比HDDT组更多。然而，在第8周时，HDDT组和BQT组中这些物种的丰度均恢复到先前水平。
与BQT相比，HDDT对肠道微生物群的多样性和组成影响较小。
ChiCTR2100053268。
