根除幽门螺杆菌感染失败与CYP2C19基因变异关系研究.docVIP

根除幽门螺杆菌感染失败与CYP2C19基因变异关系研究 　　[摘要] 目的探讨根除幽门螺杆菌（Hp）感染失败与CYP2C19基因变异关系。 方法收集本院诊断为慢性胃炎、胃溃疡和反流性食管炎经标准奥美拉唑三联治疗失败60例，以CYP2C19 基因型分组，再以埃索美拉唑三联治疗1周后复查14C，并判断Hp根除情况。结果60例Hp根除失败患者可分为CYP2C19 基因强代谢型和弱代谢型两组，组间年龄、病种、性别比较差异无统计学意义，民族分布差异有统计学意义。经埃索美拉唑三联治疗后，CYP2C19强代谢型组Hp根除率为93.9%，弱代谢型组Hp根除率为100%，两组患者Hp根除无统计学意义。结论根除Hp感染失败与CYP2C19基因变异关系紧密。 　　[关键词] 根除幽门螺杆菌；CYP2C19；变异 　　[中图分类号] R573.3[文献标识码] B[文章编号] 1673-9701（2012）10-0145-02 　　Study the relationship between eradication of Helicobacter Pylori infection and CYP2C19 genetic mutation 　　MIUYangde 　　Department of Gastroenterology，Taizhou Municipal Hospital in Zhejiang Province, Taizhou 318000，China 　　[Abstract] Objective To analyze the relationship between eradicate of Helicobacter pylori infection and CYP2C19 genetic mutation. Methods All of 60 patients diagnosed chronic gastritis，gastric ulcer or reflux esophagitis who underwent standard omeprazole triple therapy and failed to eradicate Hp in our hospital were enrolled in our study.CYP2C19 genotypes separated 60 cases into two groups.Then esomeprazole triple therapy was applied for 1 week.After treatment，14C-urea breath test was done to determine the Hp eradication situation. Results All of 60 patients with failure Hp eradication with CYP2C19 gene were divided into strong and weak metabolic type groups.Age，disease type had no significant differences，while ethnic distribution has differences.After esomeprazole triple therapy，CYP2C19 strong metabolizers’Hp eradication rate was 93.9%，weak metabolizers’100%.There was no difference for two group’s Hp eradication rates. Conclusion Failure eradication of Helicobacter pylori infection and CYP2C19 genetic mutation are closely related. 　　[Key words] Eradication of Helicobacter Pylori; CYP2C19; Mutation 　　CYP2C19是1993年Wrighton等从人类肝脏中分离出的一种酶，后来Goldstein等发现其对代谢存在遗传多态性。质子泵抑制剂（PPI）在药动学、药效学等方面高度依赖CYP2C19进行代谢，并受CYP2C19基因变异的影响，但不同的质子泵抑制剂对CYP2C19的依赖程度不同，可能与CYP2C19基因变异有关[1-3]。本研究旨在探讨对CYP2C19依赖程度有差异的PPI药物对幽门螺杆菌（Hp）根除的关系，现报道如下。 　　 　　1 资料与方法 　　1.1一般资