左氧氟沙星治疗幽门螺杆菌感染研究  

The study of levofloxacin in Helicobacter pylori infection

作　　者：罗玲玲[1] 胡咏梅[2,3] 张磊[1] 胡兴萍[1] 许建明[1] 

机构地区：[1]安徽医科大学第一附属医院消化内科,合肥230032 [2]安徽医科大学第一附属医院科研处,合肥230032 [3]安徽省消化系统疾病重点实验室,合肥230032

出　　处：《中国临床药理学杂志》2013年第8期578-580,586,共4页The Chinese Journal of Clinical Pharmacology

基　　金：国家自然基金青年基金资助项目(81100269)

摘　　要：目的探讨左氧氟沙星三联7 d和10 d疗法用于初次治疗幽门螺杆菌(Hp)感染的疗效及胃粘膜左氧氟沙星浓度对Hp根除效果的影响。方法共收集我院门诊240例Hp阳性的慢性胃炎患者,随机分为左氧氟沙星三联7 d组(n=120)和左氧氟沙星三联10 d组(n=120)。2组均口服埃索美拉唑20 mg+阿莫西林1000 mg,每天2次,左氧氟沙星500 mg,每天1次。前者疗程7 d,后者疗程10 d。7 d疗程组中61例患者于根除治疗结束后第1 d行胃镜检查,于胃窦部取材4块,用HPLC法测定胃粘膜中左氧氟沙星浓度。2组患者根除治疗结束4周后,复查14C呼气试验判断根除结果。结果共有224例患者完成随访,左氧氟沙星三联10 d组和7 d组,意向治疗(ITT)分析Hp根除率分别为81.7%,78.3%;符合方案(PP)分析Hp根除率分别为88.3%,83.2%,2组间比较差异无统计学意义(P>0.05)。Hp根除失败组患者胃粘膜左氧氟沙星的浓度为(4.87±1.71)μg.g-1,Hp根除成功组患者胃粘膜左氧氟沙星的浓度为(7.16±2.10)μg.g-1,2组间比较差异有统计学意义(P<0.05)。结论左氧氟沙星三联7 d疗法与左氧氟沙星三联10 d疗法Hp根除率相近。Hp根除成功患者胃粘膜内左氧氟沙星的药物浓度高于Hp根除失败患者。Objective To observe the therapeutic effect of 7 days of leofloxacin regimen and 10 days of leofloxacin regimen as the initial therapy for Helicobacter pylori（Hp） infection and the impact of the concentration of levofloxacin in gastric mucosa on the eradication of H.pylori.Methods A total of 240 patients with Hp infection suffering from chronic gastritis were randomly divided into 7 days of levofloxacin-based triple regime group（n = 120） and 10 days of levofloxacin-based triple regime group（n = 120）.All patients received therapy with esomeprazole 20 mg twice a day plus amoxicillin 1000 mg twice a day and levofloxacin 500 mg once a day,the former group for 7 days,the latter group for 10 days.Sixty-one patients of the 7 days of levofloxacin-based triple regime group received gastroscopy and were drawn four pieces of mucosal tissue from antrum on the first day after the end of treatment.The concentration of levofloxacin in gastric mucosa was determined by HPLC.H.pylori status was rechecked by 14C-urea breath test 4 weeks after the end of therapy.Results A total of 224 patients completed the follow up.The eradication rate in intention to treat（ITT） and per protocol（PP） analyses were：7 days of levofloxacin-based triple regime group 80.0%,88.5% and 10 days of levofloxacin-based triple regime group 75.8%,82.0%.No significant difference was found between the two triple therapies（P 0.05）.The concentration of levofloxacin in gastric mucosal were（7.16 ± 2.10） μg.g-1 in successful eradication of H.pylori group patients,and（4.87 ± 1.71） μg.g-1 in the failure group,and there was statistically significant difference between the two groups（P 0.05）.Conclusion The eradication rate of H.pylori infection in 7 days of levofloxacin-based triple therapy group was similar with 10 days of levofloxacin-based triple therapy group.The concentration of levofloxacin in the gastric mucosal was higher in the group which was successful to eradicate H.pylori infection than in the group which was failed to

关 键 词：左氧氟沙星 胃粘膜 药物浓度 幽门螺杆菌 

分 类 号：R978.19[医药卫生—药品]