临床药物治疗杂志
臨床藥物治療雜誌
림상약물치료잡지
Clinical Medication Journal
2015年
5期
36-40
,共5页
西娜%赵冠人%王雪明%李倩
西娜%趙冠人%王雪明%李倩
서나%조관인%왕설명%리천
细胞色素P450 2C19%基因多态性%雷贝拉唑%奥美拉唑%四联治疗%螺杆菌,幽门%胃溃疡
細胞色素P450 2C19%基因多態性%雷貝拉唑%奧美拉唑%四聯治療%螺桿菌,幽門%胃潰瘍
세포색소P450 2C19%기인다태성%뢰패랍서%오미랍서%사련치료%라간균,유문%위궤양
cytochrome p450 2C19%gene polymorphism%rabeprazole%omeprazole%quadruple chemotherapy%helicobacter pylori%gastric ulcer
目的：分析CYP2C19基因多态性对雷贝拉唑和奥美拉唑四联治疗幽门螺杆菌(Hp）阳性胃溃疡疗效的影响。方法：选取Hp阳性胃溃疡患者168例，随机分为2组。观察组接受雷贝拉唑四联疗法，对照组接受奥美拉唑四联疗法，治疗结束4周后比较2组患者胃肠道症状改善情况、临床疗效、Hp根除率及不良反应发生情况。同时利用DNA微阵列芯片法检测患者的CYP2C19基因型，观察基因型对两组药物疗效的影响。结果：观察组治愈率72.62%，总有效率89.28%，Hp根除率95.23%，对照组治愈率58.34%，总有效率72.62%，Hp根除率86.90%，两组差异显著（P<0.05或P<0.01）。观察组中，快代谢型（EM）治愈率61.12%，中间代谢型（IM）80.00%，弱代谢型（PM）84.62%， EM型与IM及PM型间差异极显著（P<0.01），IM型与PM型之间无显著性差异（P>0.05）。对照组中，EM型治愈率44.74%，IM型64.71%，PM型83.34%，3种代谢型间的治愈率差异极显著（P<0.01）。相同代谢型患者治愈率两组间比较，PM型无明显差异（P>0.05），但EM型与IM型观察组均明显高于对照组（P<0.05）。结论：雷贝拉唑四联疗法较奥美拉唑四联疗法治疗Hp阳性胃溃疡根除率更高，疗效更显著，安全性相当，且受CYP2C19基因型影响程度较小，疗效更稳定，值得临床推荐。
目的：分析CYP2C19基因多態性對雷貝拉唑和奧美拉唑四聯治療幽門螺桿菌(Hp）暘性胃潰瘍療效的影響。方法：選取Hp暘性胃潰瘍患者168例，隨機分為2組。觀察組接受雷貝拉唑四聯療法，對照組接受奧美拉唑四聯療法，治療結束4週後比較2組患者胃腸道癥狀改善情況、臨床療效、Hp根除率及不良反應髮生情況。同時利用DNA微陣列芯片法檢測患者的CYP2C19基因型，觀察基因型對兩組藥物療效的影響。結果：觀察組治愈率72.62%，總有效率89.28%，Hp根除率95.23%，對照組治愈率58.34%，總有效率72.62%，Hp根除率86.90%，兩組差異顯著（P<0.05或P<0.01）。觀察組中，快代謝型（EM）治愈率61.12%，中間代謝型（IM）80.00%，弱代謝型（PM）84.62%， EM型與IM及PM型間差異極顯著（P<0.01），IM型與PM型之間無顯著性差異（P>0.05）。對照組中，EM型治愈率44.74%，IM型64.71%，PM型83.34%，3種代謝型間的治愈率差異極顯著（P<0.01）。相同代謝型患者治愈率兩組間比較，PM型無明顯差異（P>0.05），但EM型與IM型觀察組均明顯高于對照組（P<0.05）。結論：雷貝拉唑四聯療法較奧美拉唑四聯療法治療Hp暘性胃潰瘍根除率更高，療效更顯著，安全性相噹，且受CYP2C19基因型影響程度較小，療效更穩定，值得臨床推薦。
목적：분석CYP2C19기인다태성대뢰패랍서화오미랍서사련치료유문라간균(Hp）양성위궤양료효적영향。방법：선취Hp양성위궤양환자168례，수궤분위2조。관찰조접수뢰패랍서사련요법，대조조접수오미랍서사련요법，치료결속4주후비교2조환자위장도증상개선정황、림상료효、Hp근제솔급불량반응발생정황。동시이용DNA미진렬심편법검측환자적CYP2C19기인형，관찰기인형대량조약물료효적영향。결과：관찰조치유솔72.62%，총유효솔89.28%，Hp근제솔95.23%，대조조치유솔58.34%，총유효솔72.62%，Hp근제솔86.90%，량조차이현저（P<0.05혹P<0.01）。관찰조중，쾌대사형（EM）치유솔61.12%，중간대사형（IM）80.00%，약대사형（PM）84.62%， EM형여IM급PM형간차이겁현저（P<0.01），IM형여PM형지간무현저성차이（P>0.05）。대조조중，EM형치유솔44.74%，IM형64.71%，PM형83.34%，3충대사형간적치유솔차이겁현저（P<0.01）。상동대사형환자치유솔량조간비교，PM형무명현차이（P>0.05），단EM형여IM형관찰조균명현고우대조조（P<0.05）。결론：뢰패랍서사련요법교오미랍서사련요법치료Hp양성위궤양근제솔경고，료효경현저，안전성상당，차수CYP2C19기인형영향정도교소，료효경은정，치득림상추천。
Objective: To investigate whether the effect of omeprazole and rabeprazole quadruple therapy on treatinghelicobacter pylori-positive gastric ulcer is related to CYP2C19 gene polymorphisms.Methods: 168 patients diagnosed ashelicobacter pylori-positive gastric ulcer were randomly divided into observation and control groups.The two groups were treated with rabeprazole and omeprazole quadruple therapy respectively. After 4-week treatment, the improvement of gastrointestinal symptoms, clinical efifcacy, Hp eradication rate and adverse reactions were compared between the two groups. The CYP2C19 genotypes of 168 patients were detected by DNA microarray method to observe the effect of genotype on curative effect of two groups.Results:In the observation group, the curative rate, total efifciency and eradication rate ofH.p. were 72.62%, 89.28% and 95.23% while those of the control group were 58.34%, 72.62% and 86.90%respectively. The differences between the two groups were signiifcant (P<0.05 or P<0.01). In the observation group, the curative rates were 61.12%, 80.00% and 84.62% in EM, IM and PM patients respectively.There were signiifcant differences between EM and IM (P<0.01), EM and PM (P<0.01), but not between IM and PM (P>0.05). In the control group, the curative rates were 44.74%, 64.71% and 83.34% in EM, IM and PM patients respectively.The differences in three metabolic types were extremely signiifcant (P<0.01). The curative rates of EM and IM but not PM patients from the observation group were signiifcantly higher than that of the control group (P<0.05).Conclusion: The clinical efifcacy andH.p. eradication of rabeprazole quadruple therapy for Hp positive gastric ulcer were superior to omeprazole. Moreover, rabeprazole is less affected by CYP2C19 genotype and therefore its curative effect is more stable.
