摘要
目的探究粪便23SrRNA基因检测在幽门螺旋杆菌(Hp)感染中应用,并分析克拉霉素耐药性。方法选郑州市中医院2020年6月至2022年5月期间98例消化性溃疡患者,所有患者均接受胃黏膜组织活检药敏试验、粪便23SRNA基因阳性检出率。结果经胃黏膜组织活检,共检出59例Hp阳性;经粪便23SrRNA共检出73例阳性,粪便23SrRNA对Hp阳性检出率较胃黏膜组织活检高(χ^(2)=4.547,P=0.033<0.05);两种诊断方法Kappa为0.63,一致性中等;经粪便23SrRNA检测结果为Hp阳性患者中,经药敏试验确认耐药12例、敏感45例;经粪便23SrRNA检测结果确认耐药14例、敏感43例,其耐药率、敏感率之间相比均未见统计学意义(χ^(2)=0.199,P=0.655>0.05);两种诊断方法Kappa为0.73,一致性较强;突变位点中,2143、2142、2097突变率分别为16.44%、10.96%、5.48%、1.37%。结论粪便23SrRNA对Hp阳性检出率高于胃黏膜活检Hp培养高,克拉霉素耐药率与药敏试验结果相近,提示可将其应用于Hp感染及克拉霉素耐药性分析检验中,为临床治疗方案制定提供更准确参考依据。
Objective To explore the application of stool 23SrRNA gene detection in Helicobacter pylori(HP)infection and analyze clarithromycin resistance.Methods 98 patients with peptic ulcer in Zhengzhou hospital of traditional Chinese medicine from June 2020 to may 2022 were selected.All patients received drug sensitivity test of gastric mucosa biopsy and positive detection rate of 23srna gene in feces.Results HP was detected in 59 cases by gastric mucosal biopsy;A total of 73 cases were positive by stool 23SrRNA.The positive rate of stool 23SrRNA for HP was higher than that of gastric mucosa biopsy(χ^(2)=4.547,P=0.033<0.05);Kappa of the two diagnostic methods was 0.63,with moderate consistency;Among the patients whose stool 23SrRNA test results were HP positive,drug resistance was confirmed in 12 cases and sensitivity in 45 cases;The results of stool 23SrRNA detection confirmed that 14 cases were drug-resistant and 43 cases were sensitive.There was no statistical significance between the drug-resistant rate and sensitive rate(χ^(2)=0.199,P=0.655>0.05);The kappa of the two diagnostic methods was 0.73,with strong consistency;The mutation rates of 2143,2142 and 2097 were 16.44%,10.96%,5.48%and 1.37%respectively.Conclusion The positive rate of stool 23SrRNA for HP is higher than that of gastric mucosa biopsy.The clarithromycin resistance rate is similar to the results of drug sensitivity test,suggesting that it can be used in the analysis and test of HP infection and clarithromycin resistance,and provide more accurate reference for the formulation of clinical treatment plan.
作者
王志伟
WANG Zhi-wei(Zhengzhou Hospital of Traditional Chinese Medicine Clinical Laboratory,Zhengzhou 453000,Henan Province,Chnia)
出处
《罕少疾病杂志》
2023年第3期82-83,103,共3页
Journal of Rare and Uncommon Diseases
作者简介
第一作者/通讯作者:王志伟,男,主管检验技师,主要研究方向:细菌感染与耐药性。E-mail:shengchaoxue2502@126.com。
