耐药性幽门螺旋杆菌感染患者胃内菌群特征分析

胡堃苗; 周利民; 余振华

doi:10.16766/j.cnki.issn.1674-4152.004249

耐药性幽门螺旋杆菌感染患者胃内菌群特征分析

doi: 10.16766/j.cnki.issn.1674-4152.004249

浙江省人民医院淳安分院消化内科，浙江杭州 311700

基金项目:

浙江省医药卫生科技计划(临床研究应用项目) 2022KY1073

详细信息

通讯作者:
周利民，E-mail：744724614@qq.com

中图分类号: R573 R378.2
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出版历程
- 收稿日期: 2025-02-14
- 网络出版日期: 2026-01-07

Characteristics of gastric microbiota in patients with drug-resistant Helicobacter pylori infection

Department of Gastroenterology, Chun' an Branch of Zhejiang Provincial People' s Hospital, Hangzhou, Zhejiang 311700, China

摘要

摘要: 目的幽门螺旋杆菌感染与慢性胃炎、消化性溃疡、胃癌等多种胃部疾病的发生发展密切相关，其耐药机制复杂，传统根除方案失败率高，而胃内菌群可能通过调节局部微环境或介导抗生素代谢影响幽门螺杆菌耐药性。本研究旨在分析耐药性幽门螺旋杆菌感染患者胃内菌群特征。方法选取2023年1月—2024年6月浙江省人民医院淳安分院收治的幽门螺旋杆菌感染患者184例作为研究对象，均进行药敏检查，根据药敏检查结果分为单耐药组、双重耐药组和多重耐药组。所有患者均留取胃部组织样本，基于16S rRNA测序检测胃内菌群特征，包括α多样性(Simpson指数和Shannon指数)和β多样性(基于主成分分析)，采用LEfSe分析筛选出各组间差异显著的菌属。结果 3组患者α多样性的Shannon指数、Simpson指数比较差异均有统计学意义(P < 0.05), 其中单耐药组Shannon指数(2.54±0.45)最低, Simpson指数(0.67±0.15)最高, 多重耐药组Shannon指数(4.26±0.34)最高, Simpson指数(0.44±0.11)最低(P < 0.05)。主成分分析显示, 3组样本间多样性差异较大(35.6% vs. 27.8%)。结论不同耐药性幽门螺旋杆菌感染患者胃内菌群呈现出显著的多样性差异。
- 幽门螺旋杆菌感染 /
- 耐药性 /
- 多重耐药 /
- 菌群特征
Abstract: Objective Helicobacter pylori (H. pylori) infection is closely related to the occurrence and development of various gastric diseases, such as chronic gastritis, peptic ulcer disease, and gastric cancer. However, its mechanisms of drug resistance are complex, and the failure rate of traditional eradication programs remains high. Emerging evidence suggests that the gastric microflora may affect H. pylori drug resistance by regulating the local microenvironment or mediating antibiotic metabolism. This study aimed to analyze the characteristics of the gastric bacterial flora in patients with drug-resistant H. pylori infection. Methods A total of 184 patients with Helicobacter pylori infection admitted to Chun' an Branch of Zhejiang Provincial People' s hospital from January 2023 to June 2024 were selected as the study objects, and all of them were tested for drug sensitivity. According to the results of drug susceptibility test, the patients were divided into the single-drug resistance group, the double-drug resistance group, and the multiple-drug resistance group. Gastric tissue samples were collected from all patients, and the characteristics of gastric microbiota were detected based on 16srRNA sequencing, including α diversity (Simpson index and Shannon index) and β diversity (based on principal component analysis). LEfSe analysis was used to identify bacteria genera with significant differences among all groups. Results Significant differences were observed in the alpha-diversity indices (Shannon and Simpson) among the three patient groups (P < 0.05). The mono-resistant group exhibited the lowest Shannon index (2.54±0.45) and the highest Simpson index (0.67±0.15), whereas the multidrug-resistant group demonstrated the highest Shannon index (4.26±0.34) and the lowest Simpson index (0.44±0.11), P < 0.05. Principal component analysis revealed considerable diversity disparities among the groups (35.6% vs. 27.8%). Conclusion The gastric microbiota composition and diversity differ significantly among patients with varying degrees of H. pylori drug resistance.
- Helicobacter pylori infection /
- Drug resistance /
- Multiple-drug resistance /
- Microbiota characteristics

HTML全文

图 1 3组幽门螺旋杆菌感染患者胃内菌群的α多样性箱式图

注：^aP < 0.05。

Figure 1. Box plot showing α-diversity of the gastric microbiota across three groups of patients with H. pylori infection

下载: 全尺寸图片幻灯片

图 2 3组幽门螺旋杆菌感染患者胃内菌群的β多样性

Figure 2. β-diversity of gastric microbiota in the three groups of patients with H. pylori infection

下载: 全尺寸图片幻灯片

图 3 耐药性幽门螺旋杆菌感染患者胃内差异菌属分析

Figure 3. Analysis of gastric microbiota differences in patients with drug-resistant H. pylori infection

下载: 全尺寸图片幻灯片

表 1 3组幽门螺旋杆菌感染患者胃内菌群的α多样性对比(x±s)

Table 1. Comparison of gastric microbiota α-diversity among the three groups of patients with H. pylori infection (x±s)

组别	例数	Shannon指数	Simpson指数
单耐药组	81	2.54±0.45	0.67±0.15
双重耐药组	75	3.13±0.36	0.50±0.13
多重耐药组	28	4.26±0.34	0.44±0.11
F值		195.739	44.142
P值		< 0.001	< 0.001

下载: 导出CSV

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