摘要目的对耐药背景指导下根除幽门螺杆菌（ HP）的效果进行评价。方法对271例符合纳入标准的HP感染患者进行前瞻性队列研究。入选的13 C尿素呼气试验阳性患者根据HP分离培养是否成功分为2组：HP培养阳性组184例，HP培养阴性组87例。 HP培养阳性组根据患者自身感染菌株的药敏结果制定个体化治疗方案，HP培养阴性组则依据温州地区人群HP耐药背景资料制定治疗方案，治疗结束8周后进行13 C尿素呼气试验，确定是否根除成功。采用χ2检验对2组治疗效果进行评价。结果 HP培养阳性组184例，常用抗生素耐药性分析发现，克拉霉素耐药率为17?9％（33／184），左氧氟沙星耐药率为28?8％（53／184），甲硝唑耐药率为97?8％（180／184），通过个体化治疗HP根除率为90?2％（166／184），HP培养阴性组87例，依据耐药背景治疗HP根除率为87?4％，两者之间差异无统计学意义（χ2＝0?506，P＝0?477）。结论基于地区耐药背景指导下的HP根除策略取得了较高的根除率，可以作为一种新的治疗方案应用于临床。

abstractsObjective To evaluate the efficacy of Helicobacter pylori ( HP ) eradication therapy based on the antibiotic resistance background of the local population. Methods A total of 271 patients in?fected by HP( 13 C?urea breath test positive) were enrolled in this prospective cohort study. According to the results of HP isolation results, patients were divided into two groups, HP?isolation positive group ( 184 cases) and HP?isolation negative group ( 87 cases) . The eradication therapy of HP?isolation positive group was based on the antibiotic resistance test results, while that of the negative group was determined by antibi?otic resistance status of local population. All patients received 13 C?urea breath test 8 weeks after the therapy. The eradication rates of different treatments were tested by the chi?squared test. Results HP?isolation posi?tive group included 184 cases,and analysis of antibiotic resistance showed that resistance rates of clarithromy?cin, levofloxacin and metronidazole were 17?9% (33/184), 28?8% (53/184), and 97?8% (180/184) re?spectively. HP eradication rate was 90?2%( 166/184 ) after individual treatment. HP?isolation negative group included 87 cases, and the eradication rate of HP based on the antibiotic resistance background was 87?4%. There was no statistical difference between two groups (χ2=0?506,P=0?477) . Conclusion Ther?apy based on the demographic drug resistance background yields to high eradication rate of HP, which could be used as a new apporach in the HP treatment.