幽门螺杆菌对含左氧氟沙星三联药物组合的耐药现状研究  

作　　者：汪望月[1] 张晔[1] 陈光兰[1] 叶洁桐[1] 邹巯梅 朱雅碧[1] 

机构地区：[1]浙江省丽水市人民医院,323000

出　　处：《浙江临床医学》2016年第6期1026-1027,1030,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省丽水市科技项目（2012ze043）

摘　　要：目的了解丽水地区幽门螺杆菌（HP）的耐药现状，探讨在该地区采用埃索美拉唑、左氧氟沙星和阿莫西林三联疗法进行HP根除治疗的可行性。方法选择2014年1月至12月进行胃镜检查的9644例患者为观察对象，取胃黏膜组织进行HP菌株分离鉴定。从HP阳性患者中随机各抽取100例病例分别纳入含左氧氟沙星7d和10d治疗组。两组分别给予左氧氟沙星（500mg，1次／d）、阿莫西林（1g2次／d）和埃索美拉唑（20mg，2次／d）治疗7d和10d。结果9644例患者HP培养阳性率为56．27％，7d治疗组和10d治疗组的HP根除率分别为69％和72％。两组根除率、不良反应发生率差异无统计学意义（P〉0．05），两组病症舒缓率差异均有统计学意义（P〈0．05），根除成功者和失败者之间胃黏膜左氧氟沙星浓度差异存在统计学意义（P〈0．05）。结论丽水地区HP感染率较高，传统的含左氧氟沙星的三联疗法已不适合作为根除治疗方案，应通过采用含铋剂的四联方案或提高左氧氟沙星和质子泵抑制剂（PPI）的临床使用剂量来提高HP的根除率。Objective To realize drug resistance present situation of helicobacter pylori （ Hp ） in Lishui region and discuss the possibility to choose the Esomeprazole, levofloxacin and amoxicillin as the HP eradication therapy. Methods The patients undergoing gastroscopy in our hospitals from January 2014 to December 2014 were seleted as the research objects. Isolate and identiflcate of HP strains from the gastric mucosal tissues. Select 100 cases randomly into 7 days and 10 days treatment groups from the cases of HP positive, The two groups were given levofloxacin （ 500mg qd ） , amoxicillin （ 1 g bid ） and esomeprazole （ 20mg bid ） for 7 days and 10 days. Results 9644 cases were enrolled in this study and the overall infection rate of Hp was 56.27% （ 5427/9644 ） . The HP eradication rate of the 7 day treatment group and the 10 day treatment group was 69% and 72% respectively. There was no significant difference in the eradication rate and adverse reaction rate between the two groups （ P〉0.05 ） . There was a significant difference in symptom relief rate between the two groups （ P〈0.05 ） . There was a significant difference in the concentration of levofloxacin in the gastric mucosa between the winner and the losers （ P〈0.05 ） . Conclusion The HP infection rate is so high in Lishui area. The traditional triple therapy with levofloxacin is not suitable for the HP eradication treatment. The bismuth containing quadruple therapy or the improvement of the clinical dosage of levofloxacin and PPI may be used to improve the eradication rate of HP infection.

关 键 词：幽门螺杆菌 耐药 左氧氟沙星 三联疗法 

分 类 号：R521[医药卫生—内科学]