| Aims1.To explore the correlation between Helicobacter pylori(Hp)infection and gastric mucosal intestinal metaplasia(IM);2.To analyze the drug susceptibility of Hp to the commonly used antibacterial drugs and investigate the anti-Hp effect of Chitooligosaccharide(COS).Methods1.From 2006 to 2019,the medical records of 132368 gastritis patients who underwent gastroscopy examination in Qingdao Municipal Hospital were respectively reviewed.Multivariate logistic regression was used to identify the potential risk factors associated with IM;The Hp infection and IM rate were calculated and compared based on different age and gender groups.2.Seventy-two patients with chronic non-atrophic gastritis diagnosed by gastroscopy and pathological examination in Qingdao Municipal Hospital were enrolled from 2016 to2018.The gastric mucosal tissues were collected for the isolation and culture of Hp strains.E-test was used to evaluate the drug susceptibility of Hp to clarithromycin,levofloxacin and metronidazole,through which the multi-drug resistant Hp strain Hp036was obtained.Disc diffusion method was conducted to investigate the antimicrobial activity of different concentrations of COS solution on the Hp036 strain by measuring and comparing the bacteriostatic ring diameters(taking 0g/L COS solution as control group).ResultsPartⅠCorrelation analysis of Helicobacter pylori infection and intestinal metaplasia of gastric mucosa1.Multivariate logistic regression analysis showed that Hp infection(OR=1.487,95%CI=1.449-1.527,P<0.001),elderly(OR=1.038,95%CI=1.037-1.039,P<0.001)and male(OR=1.264,95%CI=1.234-1.286,P<0.001)had a positive correlation with IM.2.The infection rate of Hp in the IM gastritis group was 35.2%(13906/39529),which was significantly higher than that in the non-IM gastritis group(35.2%vs 29.5%,χ~2=400.480,P<0.001),suggesting that Hp may be a potential risk factor for the development of IM.3.With the growth of age,the IM incidence showed an increasing trend(χ~2=4484.890,P for trend<0.001),and reached a high plateau after the age of 60.While the Hp infection rate increased along with age before the age of 40,reaching a peak at 30-39,and gradually decreased after 40.In patients aged≥60 years,although the Hp infection rate decreased,IM remained high incidence.The above results suggested that besides Hp infection,old age may be an important factor in the occurrence of IM.Part Ⅱ The status of multi-drug resistance of Helicobacter pylori and the anti-Hp effect of chitosan oligosaccharide1.E-Test susceptibility testing showed that only 16.6%(10/60)of Hp strains remained sensitive to all the three antibiotics,clarithromycin(CLA),metronidazole(MTZ),and levofloxacin(LVX).The single resistance rates of Hp strains to the above three antibiotics were 41.6%,40.0%and 33.3%respectively;while the double resistance rates of Hp strains fluctuated from 3.3%to 11.6%.The proportion of triple antibiotic resistance of Hp strain is 8.3%(5/60).The high prevalence of single-resistant and multi-resistant Hp strains may seriously affect the Hp eradication efficacy.2.COS anti-Hp effect:After incubation with different concentrations of COS,the Hp036culture medium showed different sizes of bacteriostatic rings.Compared with the control group,COS group(except for 2 g/L concentration)demonstrated significantly larger bacteriostatic ring(P<0.05),and with the increase of chitosan oligosaccharide concentration,the antibacterial ability gradually enhanced.Conclusions1.Hp infection,old age and male may be independent risk factors for the development of IM.2.IM is related to HP infection and aging.The effect of HP is decreased after the age≥60 years old.3.The isolated Hp strains show a high rate of single and multiple resistance.4.COS demonstrates a certain inhibitory effect on Hp proliferation in vitro. |
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