药敏试验指导根除幽门螺杆菌治疗的临床研究  

Study of drug sensitivity test in helicobacter pylori eradication therapy

作　　者：王改芹[1] 赵清喜[2] 李森林[3] 

机构地区：[1]山东聊城职业技术学院,252000 [2]山东青岛大学医学院附属医院消化内科 [3]山东聊城市人民医院消化内科

出　　处：《临床内科杂志》2008年第7期474-477,共4页Journal of Clinical Internal Medicine

摘　　要：目的观察根据药敏结果选择两种敏感抗生素加奥美拉唑三联1周疗法治疗幽门螺杆菌(Hp)的根除率,探讨幽门螺杆菌药敏试验对根除幽门螺杆菌的指导作用。方法选择经胃镜确诊的幽门螺杆菌阳性慢性胃炎和消化性溃疡患者120例,将120例患者分为三组,各40例。Hp培养组:经胃镜取患者胃窦黏膜组织进行幽门螺杆菌培养和药敏试验,根据药敏结果选择两种敏感抗生素加奥美拉唑治疗,疗程1周;OAM组:奥美拉唑20 mg、阿莫西林1.0、甲硝唑0.4,每天2次,疗程1周;OAC组:奥美拉唑20 mg、阿莫西林1.0、克拉霉素0.5,每天2次,疗程1周;一个月后检测幽门螺杆菌根除情况,观察Hp根除率。结果Hp培养组、OAM组和OAC组的根除率分别为97.3%、76.3%和77.8%。Hp培养组与其他两组间Hp根除率比较差异均有显著性(P<0.05),OAM组和OAC组间Hp根除率比较差异无显著性(P>0.05)。结论根据药敏结果选择两种敏感抗生素加奥美拉唑三联1周疗法治疗Hp感染可获得较高的根除率,是根除Hp的理想方案;幽门螺杆菌药敏试验对临床幽门螺杆菌菌株的根治有指导作用。Objective To observe the efficacy of 1-week triple therapy of omeprazole and two an- timierobial agents by drug sensitivity test for helleobaeter pylori（HP） eradication ,to study sensitivity of HP to antimierobial agents, and to provide clinical evidence of choosing antimierobial agents. Methods One hundred and twenty patients with HP infection suffered from chronic gastritis and peptic ulcer were randomized to HP culture group, OAM group and OAC group. The eases of HP culture group were administered omeprazole（20 mg, twice a day）and two antimierobial agents according to drug sensitivity test;The eases of OAM group were administered omeprazole（20 mg, twice a day） , Amoxieilin（ 1.0, twice a day ） and metronidazole（ 0.4, twice a day） ;The eases of OAC group received omeprazole（ 20 mg, twice a day） , Amoxieilin（ 1. 0, twice a day ） and elarithromyein（0. 5, twice a day）, all the treatment time lasted for 1- week. Four weeks later,the HP eradication rate were observed. Results The eradication rate in HP culture group ,OAM group and OAC group were 97.3% ,76.3% 和 77.7% , respectively. The difference of eradication rate between HP culture group and the other two groups was significant （ P 〈 0. 05 ）, and there was no difference between OAM and OAC groups （ P 〉 0.05 ）. Conclusions 1 -week triple therapy of omeprazole and two antimierobial agents according to helieobaeter pylori culture and drug sensitivity test can enhance the HP eradication rate;Helieobaeter pylori culture and drug sensitivity test can direct HP eradication therapy.

关 键 词：幽门螺杆菌 药敏试验 根治 

分 类 号：R573[医药卫生—消化系统]