The Efficacy Evaluation Study of Proton Pump Inhibitor Quadruple Therapy Based on CYP2C19 Gene Polymorphism Detection
Objective To improve the eradication rate of Helicobacter pylori infection by guiding the selection of pro-ton pump inhibitors(PPIs)quadruple therapy through CYP2C19 gene polymorphism detection.Methods A total of 400 patients with Helicobacter pylori(HP)positive infection admitted to the Department of Gastroenterology,Ningxia Zhong Shapotou People's Hospital from February to October 2023 were randomly selected as the research objects.Ac-cording to different treatment methods,they were divided into control group and study group,with 200 cases in each group.The control group was given empirical therapy.The study group used polymerase chain reaction(PCR)-fluores-cent probe technology to detect CYP2 C19 gene polymorphism.According to the specific gene test results,it was di-vided into three metabolic types,and the corresponding regimens were selected for treatment.The therapeutic effects of the two groups were compared.Results Among the patients in the study group,81 cases(40.50%)of CYP2C19*1/*1 normal metabolizers,91 cases(45.53%)of intermediate metabolizers,and 28 cases(14.00%)of poor metabolizers.The cure rate of HP infection in patients with three metabolic types:96.70%(88/91)in the intermediate metabolizers was the highest,and 78.57%(22/28)in the poor metabolizers was the lowest,the difference was statistically signifi-cant(χ2=7.643,P=0.006);there was no significant difference between the normal metabolizers and the intermediate metabolizers and the slow metabolic group(both P>0.05).The overall cure rate of the study group was 91.50%(183/200),which was higher than 60.50%(121/200)of the control group,and the difference was statistically significant(χ2=7.259,P<0.05).When the two groups were treated with pantoprazole,the cure rate of the control group was 68.92%(51/74)lower than that of the study group 90.12%(73/81),the difference was statistically significant(χ2=10.867,P<0.05);when the two groups received the same dose of omeprazole proton pump inhibitor,the cure rate of the control group was 55.56%(70/126)lower than that of the study group 92.44%(110/119),the difference was statistically sig-nificant(χ2=42.708,P<0.05).Conclusion According to the results of CYP2C19 gene polymorphism,the selection of appropriate PPIs and their doses can improve the cure rate of Helicobacter pylori infection compared with empirical therapy.
CYP2C19 Gene polymorphismProton pump inhibitorsHelicobacter pyloriPrecision medicine
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