CYP2C19基因多态性对埃索美拉唑治疗老年消化性溃疡疗效影响.docVIP

CYP2C19基因多态性对埃索美拉唑治疗老年消化性溃疡疗效影响 　　[摘要] 目的 探讨CYP2C19基因多态性对埃索美拉唑治疗老年消化性溃疡疗效的影响。 方法 选取2014年8月～2015年8月我院老年消化性溃疡患者80例，应用埃索美拉唑+阿莫西林+甲硝唑三联疗法治疗2周后，单用埃索美拉唑治疗2周的方案。采用聚合酶链式反应-限制性片段长度多态性（PCR-RFLP）分析方法对患者进行基因分型，并按基因型分为三组，纯合子强代谢者39例；杂合子强代谢者25例，弱代谢者16例。治疗前后行胃镜检查比较治疗效果。 结果 纯合子强代谢组、杂合子强代谢组和弱代谢组治疗有效率分别为82.05%、88.00%和100.00%，纯合子强代谢组的治愈率显著低于弱代谢组（P0.05）。纯合子强代谢组、杂合子强代谢组和弱代谢组Hp清除率别为46.15%、52.00%和82.15%，弱代谢型组患者的Hp清除率显著高于纯合子强代谢型和杂合子强代谢型（P0.05）。 结论 埃索美拉唑治疗老年消化性溃疡的疗效与CYP2C19基因多态性密切相关。CYP2C19基因分型检测是评价临床埃索美拉唑治疗老年性消化性溃疡疗效的一个重要的工具。 　　[关键词] 埃索美拉唑；消化性溃疡；CYP2C19；基因多态性；老年患者 　　[中图分类号] R573.1 [文献标识码] A [文章编号] 1673-9701（2016）14-0001-04 　　[Abstract] Objective To explore the effects of CYP2C19 gene polymorphism on the curative effects of esomeprazole in the treatment of elderly peptic ulcer. Methods A total of 80 patients with elderly peptide ulcer in our hospital from August 2014 to August 2015 were selected. After the triple therapy of esomeprazole+amoxicillin+metronidazole was applied in the treatment for 2 weeks， the protocol of single administration of esomeprazole for 2 weeks was applied. An analyzing method of PCR-RFLP was applied to perform genetic typing in the patients， and the patients were divided into three groups according to the genotype： 39 patients of homozygote extensive metabolizers； 25 patients of heterozygote extensive metabolizers； 16 patients of poor metabolizers. Gastroscopy was applied before and after the treatment， and curative effects were compared. Results The treatment effective rate in homozygote extensive metabolizer group， heterozygote extensive metabolizer group and poor metabolizer group was 82.05%， 88.00% and 100.00% respectively. The recovery rate in the homozygote extensive metabolizer group was significantly lower than that in the poor metabolizer group（P0.05）. Hp clearance rate in homozygote extensive metabolizer group， heterozygote extensive metabolizer group and poor metabolizer group was 46.15%， 52.00% and 82.15% respectively， and Hp clearance rate in poor m