Analysis of Clinical Factors Influencing Helicobacter pylori Eradication in Chronic Gastritis Patients

Background: Helicobacter pylori (H.pylori) infection is closely correlated with chronic gastritis and peptic ulcer disease.However,triple therapy which is widely applied in clinical practice is not effective on eradicating H.pylori in a certain proportion of patients.Aims: To investigate the clinical factors influencing H.pylori eradication in patients with chronic gastritis.Methods: Endoscopic biopsy specimens from 128 H.pylori-positive chronic gastritis patients were taken for H.pylori culture and antibiotic sensitivity test.Patients were treated by triple therapy including omeprazole, metronidazole and clarithromycin for 7 days.CYP2C19 genotype was determined by PCR-RFLP.Effect of various factors on H.pylori eradication rate was analyzed.Results: A total of 123 patients had completed a course of treatment, H.pylori eradication rates by ITT analysis and by PP analysis were 66.4% and 69.1%,respectively.The resistance rates of H.pylori to metronidazole and clarithromycin were 48.4% and 14.1%,respectively.The eradication rate of H.pylori in smokers was significantly lower than that in non-smokers (37.0% vs.88.3% ,P 0.01).The eradication rates of metronidazole-sensitive and clarithromycin-sensitive strains were significantly higher than those of metronidazole-resistant and clarithromycin-resistant strains (90.5% vs.46.7%,P0.01; 76.6% vs.18.8%,P0.01).The eradication rate of H.pylori in CYP2C19 extensive metabolizers was significantly lower than that in poor metabolizers (63.4% vs.86.7%,P 0.05).Age,gender and alcohol consumption did not significantly effect the eradication rate of H.pylori (all P0.05). Conclusions: Resistance of H.pylori to antibiotics and CYP2C19 extensive metabolizer are two important factors causing H.pylori eradication failure.Smoking also increases the failure rate of H.pylori eradication.