左氧氟沙星三联疗法在幽门螺杆菌补救治疗中的疗效  

Efficacy of Levofloxacin-based Triple Therapy as Second-line Treatment for Helicobacter pylori Infection

作　　者：郑小丽[1] 许乐[1] 

机构地区：[1]卫生部北京医院消化内科,北京100730

出　　处：《中国医药导刊》2013年第4期554-555,共2页Chinese Journal of Medicinal Guide

摘　　要：目的:评价含左氧氟沙星的三联疗法在幽门螺杆菌(Hp)补救治疗中的有效性和安全性。方法:将Hp感染根除治疗失败的126例患者随机分为A组(61例)和B组(65例)。A组患者给予含左氧氟沙星的三联疗法(左氧氟沙星+埃索美拉唑镁肠溶片+阿莫西林),B组患者给予常规四联补救治疗(埃索美拉唑镁肠溶片+胶体果胶铋+克拉霉素+甲硝唑),疗程均为10天,治疗结束后4周做13C尿素酶呼气试验比较Hp根除疗效。结果:A组56例完成治疗及随访,其中47例补救治疗成功,其按意向治疗(ITT)Hp根除率和按符合方案(PP)Hp根除率分别为77.0%(47/61)和83.9%(47/56);B组59例完成治疗及随访,45例根除治疗成功,其ITT根除率和PP根除率分别为69.2%(45/65)和76.3%(45/59),差异均无统计学意义(P>0.05)。结论:对既往Hp根除治疗失败的患者,左氧氟沙星+阿莫西林+埃索美拉唑10天疗法是可供选择的补救治疗方案。Objective：To evaluate the efficacy and tolerability of a second-line triple-regimen-containing levofloxacin in patients whose Helicobacter pylori eradication treatment failed.Methods：A total of 126 patients, in whom the initial standard PPI triple therapy had failed to eradicate H.pylori infection,were included in the study.Patients were randomized to one of the following 10-day treatment regimens：（1）Esomeprazole 20 mg twice a day,levofloxacin 500 mg/day,amoxicillin 1000mg twice a day;（2）Esomeprazole 20mg twice a day,bismuth salts 150mg three times a day,clarithromycin 500mg twice a day,metronidazole 400mg twice a day.H.pylori status was re-assessed with the 13C-urea breath test four weeks after the end of therapy.Results：The intention-to-treat （ITT） and per-protocol （PP） eradication rates were 77.0% （47/61） and 83.9% （47/56） in the levofloxacin-based triple group,and 69.2% （45/65） and 76.3% （45/59） in the bismuth-based quadruple group, respectively.Conclusion：Ten-day levofloxacin-containing therapy is an encouraging second-line strategy,providing a safe and simple alternative to quadruple therapy in patients whose previous standard triple therapy has failed.

关 键 词：幽门螺杆菌 左氧氟沙星 补救治疗 

分 类 号：R57[医药卫生—消化系统]