HELICOBACTER PYLORI INFECTION: CYP2C19 GENOTYPE AND SERUM FERRITIN Randomized open trial for comparison of proton pump inhibitors in triple therapy for Helicobacter pylori infection in relation to CYP2C19 genotype
HELICOBACTER PYLORI INFECTION: CYP2C19 GENOTYPE AND SERUM FERRITIN Randomized open trial for comparison of proton pump inhibitors in triple therapy for Helicobacter pylori infection in relation to CYP2C19 genotype
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幽门螺杆菌感染：CYP2C19 基因型和血清铁蛋白 比较质子泵抑制剂三联疗法治疗幽门螺杆菌感染与 CYP2C19 基因型相关的随机开放试验
DOI：
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发表时间：
2002
期刊：
影响因子：
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通讯作者：
T. Tsuji
中科院分区：
文献类型：
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作者：
T. Inaba;M. Mizuno;K. Kawai;K. Yokota;K. Oguma;M. Miyoshi;Susumu Take;H. Okada;T. Tsuji
背景与目的：细胞色素P450(Cyp)2C19基因多态性影响质子泵抑制剂(PPI)和阿莫西林根除幽门螺杆菌的疗效。然而，在三联疗法(PPI+阿莫西林和克拉霉素)中，对CYP2C19基因多态性的影响或使用雷贝拉唑的影响知之甚少，因为雷贝拉唑不能被CYP2C19很好地代谢。比较三种PPI(奥美拉唑、兰索拉唑和雷贝拉唑)在为期一周的三联疗法中的疗效与细胞色素P2C19基因多态性的关系。方法：183例患者随机分为阿莫西林5 0 0 mg tid、克拉霉素2 0 0 mg tid和PPI(奥美拉唑2 0 mg、兰索拉唑30 mg、雷贝拉唑10 mg)，2次/d。用聚合酶链式反应限制性片段长度多态分析方法分析细胞色素P450 2C19基因的多态性。结果：奥美拉唑、兰索拉唑和雷贝拉唑方案基于意向治疗的总治愈率分别为83.1%(95%可信区间：69~%)、86.7%(CI：75~93%)和76.6%(CI：~85%)，差异无统计学意义。雷贝拉唑方案的治愈率(而兰索拉唑和奥美拉唑方案不相关)倾向于与细胞色素P450 2C19基因相关(P=0.076)。在具有广泛代谢物纯合子基因的患者中，雷贝拉唑的按方案治愈率(62.5%)显著低于兰索拉唑(90.0%；P=0.038)。结论：奥美拉唑、兰索拉唑和雷贝拉唑三联疗法根除幽门螺杆菌1周后的总治愈率无显著差异，但CYP2C19基因多态性对根治率的影响在不同PPI间存在差异。©2002布莱克韦尔出版亚洲有限公司
Background and aims : Genetic polymorphism of cytochrome P450 ( CYP ) 2C19 influences the efficacy of Helicobacter pylori eradication therapy with a proton pump inhibitor (PPI) and amoxicillin. However, in triple therapy (PPI plus amoxicillin and clarithromycin), little is known about the impact of CYP2C19 polymorphism, or the use of rabeprazole, which is not well metabolized by CYP2C19 . The efficacy of three PPI (omeprazole, lansoprazole, and rabeprazole) in a 1-week triple regimen were compared in relation to CYP2C19 polymorphism. Method : One hundred and eighty-three patients were randomized to receive one of the following regimens: amoxicillin 500 mg t.i.d., clarithromycin 200 mg t.i.d., and PPI (omeprazole 20 mg, lansoprazole 30 mg, or rabeprazole 10 mg) b.i.d. CYP2C19 polymorphism was analyzed by PCR restriction fragment length polymorphism. Results : Intention-to-treat-based overall cure rates for omeprazole, lansoprazole or rabeprazole regimens were 83.1% (95% confidence interval (CI): 69–89%), 86.7% (CI: 75–93%), and 76.6% (CI: 64– 85%), respectively, without significant difference. The cure rate of the rabeprazole regimen (but not the lansoprazole or omeprazole regimens) tended to be correlated with CYP2C19 genotypes ( P = 0.076). In patients with a homozygous extensive metabolizer genotype, the per protocol-based cure rate with rabeprazole (62.5%) was significantly lower than that with lansoprazole (90.0%; P = 0.038). Conclusion : The overall cure rate of 1-week triple therapy for H. pylori eradication was not significantly different between regimens with omeprazole, lansoprazole or rabeprazole, but the impact of CYP2C19 genetic polymorphism on the cure rate appeared to differ between these PPI. © 2002 Blackwell Publishing Asia Pty Ltd
影响因子：
3.6
作者：
S. M. Morais;G. Wilkinson;J. Blaisdell;U. Meyer;K. Nakamura;J. Goldstein
通讯作者：
S. M. Morais;G. Wilkinson;J. Blaisdell;U. Meyer;K. Nakamura;J. Goldstein