治疗的依从性、年龄、性别对胃溃疡患者使用三联7天疗法根除幽门螺杆菌治疗的影响  

Helicobacter pylori eradication using a seven-day triple therapy in patients with gastric ulcer disease: comparative study of gastric ulcer subjects in compliance to therapy,age and gender

作　　者：张川[1] 袁志芳[1] 张澍田[2] 高峰[1] 阎雪燕[1] 高辉[1] 段卓洋[1] 

机构地区：[1]首都医科大学附属北京朝阳医院京西院区消化科,北京100043 [2]首都医科大学附属北京友谊医院消化科

出　　处：《胃肠病学和肝病学杂志》2009年第10期958-960,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的研究胃溃疡患者使用三联7天疗法治疗幽门螺杆菌（Helicobacter pylori,H.pylori）感染的根除率,评估患者依从性、年龄、性别对于此类人群根除H.pylori治疗的影响。方法将经胃镜检查确诊为新发胃溃疡,并经活组织病理学检查明确有H.py-lori感染的1 075例患者纳入研究范围,所有入选患者均接受三联（洛赛克或耐信20 mg/次、2次/天,联合克拉霉素500 mg/次、2次/天,与阿莫西林1 000 mg/次、2次/天）7天疗法行根除H.pylori治疗,之后予以耐信或洛赛克20 mg/次、1次/天、治疗49天。所有入选患者系统治疗完成后6-8周复查胃镜。结果40-59岁与60岁以上人群的胃溃疡患者对治疗的依从性差异无显著性,而40岁以下人群对治疗的依从性较差（P〈0.05）。〈40岁、40-59岁和≥60岁胃溃疡患者的H.pylori根除率分别为61.0%、72.7%和81.9%。〈40岁与40-59岁和≥60岁患者的H.pylori根除率差异有统计学意义（P〈0.05）。不同性别胃溃疡患者的H.pylori根除率差异无显著性（P〉0.05）。结论使用三联7天疗法治疗胃溃疡患者的H.pylori感染,H.pylori的根除率较低,患者对治疗的依从性、年龄是影响胃溃疡患者H.pylori根除率的重要因素,而性别对此无影响。Objective To observe the eradication rate of H.pylori in a gastric ulcer population uaing a seven-day triple therapy,and to evaluate the influence of compliance to therapy,age and gender on H.pylori eradication of the gastric ulcer population.Methods A series of 1 075 consecutive patients,being diagnosed as gastric ulcer disease by upper endoscopy and H.pylori infection by histological examination were included studied.All patients underwent standard triple therapy for 7 days（Losec or Nexium 20 mg bid,Clarithromycin 500 mg bid,and Amoxicillin 1 000 mg bid）.Then all patients were treatment with Losec or Nexium 20 mg qd for a period of 49 days.All patients were checked endoscopy at 6～8 weeks after completion of all the treatment.Results The compliance to therapy was not different in gastric ulcer patients of 40～59 years old and ≥60 years old,but it was weak in gastric ulcer patients of〈 60 years old（P〈0.05）.The total H.pylori eradication rate of gastric ulcer patients was 75.6%.The H.pylori eradication rates were 61.0%,72.7%,81.9% in gastric ulcer patients of 〈40 years old,40～59 years old and ≥60 years old.Compared with gastric ulcer patients of 40～59 years old and ≥60 years old,H.pylori eradication rate was significantly different in gastric ulcer patients of 40 years old（P〈0.05）.The gender did not affect H.pylori eradication rate in the three groups（P〈0.05）.Conclusion This study found a 7-day of triple therapy with amoxicillin,clarithromycin,and a proton pump inhibitor had a poor eradication rate of H.pylori infection.The compliance to therapy and age seem to affect the eradication rate of H.pylori infection of gastric ulcer.The gender did not affect H.pylori eradication rate in a gastric ulcer population.

关 键 词：幽门螺杆菌 三联疗法 胃溃疡 

分 类 号：R573.1[医药卫生—消化系统]