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題名 | Correlation of CYP2C19 Genetic Polymorphisms With Helicobacter pylori Eradication in Patients With Cirrhosis and Peptic Ulcer=肝硬化合併消化性潰瘍病患CYP2C19基因多型性與幽門螺旋桿菌清除率之關連性研究 |
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作者 | 賴啟賢; 林君隆; | 書刊名 | Journal of the Chinese Medical Association |
卷期 | 73:4 2010.04[民99.04] |
頁次 | 頁188-193+CA31 |
關鍵詞 | 幽門桿菌去除率; 消化性潰瘍; CYP2C19; Cirrhosis; Helicobacter pylori eradication; Peptic ulcer; |
語文 | 英文(English) |
英文摘要 | Background: To investigate whether or not CYP2C19 genotype status is associated with cure rate for Helicobacter pylori infection in patients with cirrhosis and peptic ulcer, achieved with 2 weeks of triple therapy with rabeprazole, amoxicillin and clarithromycin. Methods: We prospectively studied 95 consecutive patients with cirrhosis and H. pylori-infected active peptic ulcers. H. pylori infection was confirmed if any 2 of the following were positive: H. pylori DNA, histology, and rapid urease test. Patients were assigned to an open-label 2-week course of oral amoxicillin 1,000mg b.i.d., rabeprazole 20mg b.i.d. and clarithromycin 500 mg b.i.d. Subsequently, all patients received oral rabeprazole 20 mg once daily until week 8. Three months and 1 year after therapy, all patients with cirrhosis were followed up endoscopically for peptic ulcer, rapid urease test, and 13C-urea breath test. The CYP2C19 genotype status for 2 mutations associated with the extensive metabolizer phenotype was determined by polymerase chain reaction and restriction fragment length polymorphism analysis. Results: Cure rates for H. pylori infection were 80.9% (95% CI, 22.8–88.6%), 89.8% (95% CI, 50.8–90.2%), and 100% (95% CI, 62.8–100%) in the rapid-, intermediate-, and poor-metabolizer groups, respectively. Healing rates for duodenal and gastric ulcer in the 3 groups were roughly parallel with cure rates for H. pylori infection. Conclusion: The results of the genotyping test for CYP2C19 seem to predict cure of H. pylori infection and peptic ulcer in patients with cirrhosis who receive triple therapy with rabeprazole, amoxicillin, and clarithromycin. |
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