J Infect Dis：基因检测打开未来个体化根除幽门螺杆菌之门

2013-10-14 佚名丁香园

2013年10月刊发在J Infect Dis杂志上的一项最新研究显示，幽门螺杆菌（H.pylori）23S核糖体RNA基因的点突变测试阳性患者应用特定疗法可使H.pylori清除率显著高于标准三联疗法。随着幽门螺旋杆菌耐药率上升，标准的三联疗法已经受到挑战。此前证实克拉霉素耐药的幽门螺杆菌与23S核糖体RNA（rRNA）基因的点突变相关。【原文下载】为了确定基因检测对个体化疗法根除H.p

2013年10月刊发在J Infect Dis杂志上的一项最新研究显示，幽门螺杆菌（H.pylori）23S核糖体RNA基因的点突变测试阳性患者应用特定疗法可使H.pylori清除率显著高于标准三联疗法。

随着幽门螺旋杆菌耐药率上升，标准的三联疗法已经受到挑战。此前证实克拉霉素耐药的幽门螺杆菌与23S核糖体RNA（rRNA）基因的点突变相关。【原文下载】

为了确定基因检测对个体化疗法根除H.pylori的作用，来自韩国的研究者对超过1200例的患者进行了相关试验研究，受试者被分成2个对照组和1个病例组。随机分配的308例受试者组成的APC对照组的患者使用阿莫西林、雷贝拉唑和克拉霉素的标准三联疗法；APM对照组的308例患者使用阿莫西林、雷贝拉唑和甲硝唑。对病例组的616例受试者进行幽门螺杆菌的23S核糖体RNA基因的点突变测试。其中病例组有218例个体患者接受特定的治疗方案，即在无变异的情况下，使用阿莫西林、雷贝拉唑和克拉霉素，如果检测到变异，克拉霉素将被甲硝唑代替。

结果显示，接受特定的治疗方案组的的幽门螺杆菌清除率为91.2%（176/193），显著高于APC对照组（75.9% [214/282]；P＜0.001）和APM对照组（79.1% [219/277]；P＜0.001）。

研究者最后总结，通过聚合酶链反应检出克拉霉素耐药变异的H.pylori感染患者并给予特定治疗方案可取得较高的根除率，基因检测或可为未来提供个体化根除幽门杆菌治疗提供基础，不过对其成本效益仍需进行更进一步的研究。

原文检索

Lee HJ, Kim JI, Cheung DY, Kim TH, Jun EJ, Oh JH, Chung WC, Kim BW, Kim SS, Park SH, Kim JK.Eradication of Helicobacter pylori According to 23S Ribosomal RNA Point Mutations Associated With Clarithromycin Resistance.J Infect Dis. 2013 Oct;208(7):1123-30.【原文下载】

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2014-04-18 kcb069

#螺杆菌#

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2013-12-25 docwu2019

#根除#

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2014-03-04 cmj8wellington

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2013-10-16 zhouqu_8

#个体化#

25 0

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