幽门螺杆菌根除治疗效果分析  

Effect Analysis of Helicobacter Pylori Eradication

作　　者：柯金珍[1] 郑建玮[2] 谢黎崖[1] 陈丰庆[1] 洪俩和[1] 

机构地区：[1]厦门大学附属第一医院药学部,福建省厦门市361003 [2]厦门大学附属第一医院消化内科,福建省厦门市361003

出　　处：《中国全科医学》2012年第17期1909-1911,共3页Chinese General Practice

摘　　要：目的从幽门螺杆菌(Helicobacter pylori,H.pylori)根治的疗效角度,探讨影响H.pylori治疗的可能因素,以期为临床合理用药提供依据。方法对本院2010年1月—2011年9月经胃镜尿素酶检查和(或)13C-呼气试验检测H.pylori阳性患者的治疗情况进行随访,收集H.pylori治疗结果并进行统计、分析。结果患者资料完整者共502例,H.pylori总体根除率为60.76%,其中男性根除率为66.67%(164/246),女性根除率为55.08%(141/256),不同性别H.pylori根除率比较,差异有统计学意义(χ2=7.066,P<0.05)。本研究分7个年龄段(未满18岁者未纳入年龄段统计),成年人各年龄段总体H.pylori根除率比较,差异无统计学意义(P>0.05)。本研究筛选出9种不同的H.pylori根治方案,其中以质子泵抑制剂(PPI)+铋剂(B)+克拉霉素(C)+左氧氟沙星(L)方案H.pylori根除率最高(为80.49%),PPI+B+L+替硝唑(Tin)的H.pylori根除率最低(为50.00%),两种方案H.pylori根除率比较,差异有统计学意义(χ2=7.570,P<0.05);含Tin的H.pylori根除方案,除PPI+阿莫西林(A)+Tin方案外,H.pylori根除率偏低;PPI+阿莫西林双氯西林(ACL)+Tin方案H.pylori根除率为55.10%,与PPI+B+ACL+Tin方案的60.78%比较,差异无统计学意义(χ2=0.331,P>0.05)。7 d疗程方案者占63.75%,H.pylori根除率为63.44%,较其他疗程高,各疗程间H.pylori根除率比较,差异无统计学意义(χ2=3.294,P>0.05)。埃索美拉唑(Eso)与奥美拉唑(Ome)方案H.pylori根除率比较,差异有统计学意义(χ2=7.839,P=0.005,检验水准调整值为0.008)。结论 H.pylori根除率与性别、治疗方案、PPI有关,与年龄、疗程无关。Objective To explore factors that affect the outcomes of Helicobacter pylori（H.pylori） eradication.Methods A total of 502 patients who were confirmed to be with H.pylori infection by Gastroscope urease and/or 13C-UBT in our hospital between January 2010 and September 2011 were enrolled in this study.The relevant data were collected and analyzed.Results The total eradication rate was 60.76%,in which the eradication rate was 66.67%（164/246）in males and 55.08%（141/256）in females（χ2=7.066,P0.05）.The eradication rates showed no significant difference among different age groups（P0.05）.Among the 9 therapeutic regimens,PPI＋B＋C＋L achieved the highest eradication rate（80.49%）,whereas PPI＋B＋L＋Tin had the lowest one（50.00%）（χ2=7.570,P0.05）.The Tin-based regimens had low eradication rates（except PPI＋A＋Tin）.The eradication rate of PPI＋B＋ACL＋Tin was 60.78%,but it was not statistically different from PPI＋ACL＋Tin（55.10%）（χ2=0.331,P0.05）.About 63.75% of the patients applied the 7-day regimen,and the the eradication rate was 63.44%,which was higher than other regimens.The eradication rates showed no statistical difference among different treatment cycles（χ2=3.294,P0.05）.The esomeprazole group and omeprazole group had significantly different H.pylori eradication rates（χ2=7.839,P=0.005）.Conclusion The H.pylori eradication rate is related to gender,treatment scheme,and proton-pump inhibitors,but not to age and treatment cycle.

关 键 词：螺杆菌 幽门 治疗学 质子泵抑制剂 抗菌药 

分 类 号：R378[医药卫生—病原生物学]