含莫西沙星三联疗法和含左氧氟沙星三联疗法作为幽门螺杆菌感染二线治疗的比较  

Comparison of Moxifloxacin-based Triple Therapy and Levofloxacin-based Triple Therapy as Second-line Treatment for Helicobacter Pylori Infection

作　　者：黄景荣[1] 屈银宗[1] 赵莉[1] 龚承先[1] 余贻汉[1] 计春燕[1] 汪毅[1] 

机构地区：[1]湖北省新华医院消化内科,武汉430015

出　　处：《临床消化病杂志》2013年第6期368-370,共3页Chinese Journal of Clinical Gastroenterology

摘　　要：目的观察含莫西沙星三联疗法和含左氧氟沙星三联疗法治疗初治失败的幽门螺杆菌(Hp)感染的临床疗效和不良反应,并比较它们的根除率。方法将132例经标准三联疗法治疗失败的Hp感染患者随机分为A组和B组,二组均为66例。A组给予口服莫西沙星(400mg/次,1次/d)+阿莫西林(1g/次,2次/d)+泮托拉唑(40mg/次,2次/d);B组给口服予左氧氟沙星(500mg/次,1次/d)+阿莫西林(1g/次,2次/d)+泮托拉唑(40mg/次,2次/d)。两组均治疗10d,停服质子泵及抗生素4周后行14C-BUT或者13C-BUT试验检测Hp感染是否根治。结果按意向治疗分析(ITT)A组和B组的Hp根除率分别为83.33%和68.18%,有显著性差异(P=0.042);按符合方案分析(PP)A组和B组的Hp根除率分别为88.71%和72.58%,有显著性差异(P=0.023)。两组的不良反应率分别为9.1%和10.6%,无显著差异(P=0.770)。结论含莫西沙星的三联疗法治疗初治失败的Hp感染优于含左氧氟沙星的三联疗法,是一种安全而有效的Hp根除二线方案。Objective To compare the efficacy and adverse-effect of Moxifloxacin-based triple therapy and Levofloxa- cin-based triple therapy as second-line treatment for Helieobacter pylori infection. Methods One hundred and thirty-two pa- tients with failed first-line HP eradication treatment were randomly divided into 2 groups： groups A （n = 66 ） orally received moxifloxacin 400mg qd ＋ pantoprazole 40mg bid ＋ amoxicillin 1.0g bid ; group B （ n = 66） orally received Levofloxacin 500rag ＋ pantoprazole 40rag bid ＋ amoxillin 1.0g bid. The patients in both groups were treated for 10 days. The eradication rates of Hp were evaluated by 13 C-urea breath test or laC-ttrea breath test 4 weeks after the treatment. Results The rates of Hp eradi- cation in groups A and B were 83.33% and 68.18% by intention-to-treat analysis, there was significant difference （P = 0. 042 ）. The rates of Hp eradication in groups A and B were 88.71% and 72.58% by per-protocol analysis, there was significant difference （ P = 0. 023 ）. The rates of adverse- effect of the two groups were 9.1% and 10.6%. There was no significant differ- ence （P = 0. 770）. Conclusion Moxifloxaein-based triple therapy is superior to Levofloxacin-based triple therapy as second- line treatment for helicobacter pylori infection. It is an effective and safe choice.

关 键 词：幽门螺杆菌 莫西沙星 左氧氟沙星 

分 类 号：R573.1[医药卫生—消化系统]