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首页> 美国卫生研究院文献>Infection and Drug Resistance >First-line Helicobacter pylori eradication rates are significantly lower in patients with than those without type 2 diabetes mellitus
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First-line Helicobacter pylori eradication rates are significantly lower in patients with than those without type 2 diabetes mellitus

机译：患有2型糖尿病的患者的一线幽门螺杆菌根除率显着降低

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>Purpose: To assess the difference of the first-line therapy for Helicobacter pylori in patients with or without type 2 diabetes (DM) and to investigate the clinical factors influencing treatment outcomes.>Patients and methods: In total, 719 patients with H. pylori infection were treated with 7-day standard first-line triple therapy, of whom 182 did and 537 did not have DM. Propensity score matched at a 1:2 ratio – for age, sex and body mass index was performed for the two groups, yielding a DM group with 147 patients and a non-DM group with 249 matched controls for analysis. Urea breath test was performed 6–8 weeks after treatment. Clinical and laboratory parameters were collected for identifying factors associated with failed eradication.>Results: H. Pylori was eradicated in 74.1% (95% confidence interval [CI] =66.2–81.0) of the DM group and 85.3% (95% CI =80.8–89.4) of the non-DM group (p=0.005). Of 51 gastric biopsy samples cultured for H. pylori, 41 were positive. In the DM group, the rates of resistance to amoxicillin, clarithromycin, levofloxacin, and tetracycline were 0%, 50.0%, 50.0% and 0%, respectively. In the non-DM group, the comparable proportions were 2.9%, 17.1%, 22.9%, and 0%, respectively. Univariate analysis revealed that DM (Odds ratio [OR], 1.771, 95% CI, 1.167–2.668, p=0.006), clarithromycin resistance (OR, 15.273; 95% CI, 1.687–138.269; p=0.015), and amoxicillin resistance (OR, 4.672; 95% CI, 2.431–8.979; p<0.001) were independently associated with failure to eradicate H. pylori. Multivariate analysis showed that clarithromycin resistance was the major factor independently associated with failure of eradication (OR, 25.472; 95% CI, 1.549–418.956; p=0.023).>Conclusions: First-line H. pylori eradication rates in patients with DM were significantly lower than in those without DM, although neither group achieved >90% eradication.
机译：>目的：评估幽门螺杆菌一线治疗在有无2型糖尿病（DM）患者中的差异，并调查影响治疗结果的临床因素。>患者和方法： 共有719例幽门螺杆菌感染患者接受了7天的标准一线三联疗法治疗，其中182例和537例没有DM。倾向得分按1：2的比例进行匹配–两组均按年龄，性别和体重指数进行了比较，得出DM组有147例患者，非DM组有249个匹配的对照进行分析。治疗后6-8周进行尿素呼气试验。收集临床和实验室参数以鉴定与根除失败相关的因素。>结果：幽门螺杆菌在DM组和75.3％的糖尿病患者中被根除（95％的置信区间[CI] = 66.2-81.0），在85.3％非糖尿病组的百分比（95％CI = 80.8–89.4）（p = 0.005）。在为幽门螺杆菌培养的51份胃活检样本中，有41份呈阳性。在DM组中，对阿莫西林，克拉霉素，左氧氟沙星和四环素的耐药率分别为0％，50.0％，50.0％和0％。在非糖尿病组中，可比比例分别为2.9％，17.1％，22.9％和0％。单因素分析显示DM（赔率[OR]，1.771、95％CI，1.167-2.668，p = 0.006），克拉霉素耐药性（OR，15.273; 95％CI，1.687–138.269; p = 0.015）和阿莫西林耐药性（OR，4.672； 95％CI，2.431–8.979； p <0.001）与根除幽门螺杆菌失败无关。多变量分析表明，克拉霉素耐药是与根除失败独立相关的主要因素（OR，25.472； 95％CI，1.549–418.956； p = 0.023）。>结论：一线根除幽门螺杆菌DM患者的发病率显着低于无DM患者，尽管两组均未达到> 90％的根除率。

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