难治性幽门螺杆菌感染637例患者临床特征分析  

Clinical characteristic analysis of refractory Helicobacter pylori infection of 637 patients

作　　者：索宝军[1] 张雨欣 李彩玲 周丽雅[1] 宋志强[1] Suo Baojun;Zhang Yuxin;Li Cailing;Zhou Liya;Song Zhiqiang(Department of Gastroenterology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院消化科,北京100191

出　　处：《中华内科杂志》2025年第3期220-224,共5页Chinese Journal of Internal Medicine

摘　　要：目的评估我国2022幽门螺杆菌(H.pylori)感染治疗指南中对难治性感染经验性治疗推荐方案和用药原则的临床实践效果。方法回顾性分析北京大学第三医院2014年至2024年10年中637例难治性H.pylori感染患者的根除疗效、安全性和依从性,并评估影响疗效的危险因素。结果14 d铋剂四联方案的总体根除率、不良反应发生率和服药百分比分别为92.3%、40.3%和92.2%。各亚组根除率、不良反应发生率和服药百分比分别为阿莫西林+甲硝唑组合87.3%、36.4%和92.7%;阿莫西林+四环素组合91.1%、39.2%和93.7%;阿莫西林+呋喃唑酮组合92.9%、23.8%和94.0%;四环素+甲硝唑组合92.1%、47.1%和90.0%;四环素+呋喃唑酮组合94.5%、41.7%和92.0%以及呋喃唑酮+甲硝唑组合91.3%、46.3%和92.5%。依从性差是根除失败的危险因素(94.7%比64.0%,P<0.05)。不同性别、年龄、体重指数、吸烟、饮酒、既往根除次数、根除间隔时间以及根除方案分组患者的根除率差异均无统计学意义(P>0.05)。结论我国H.pylori感染治疗指南中推荐的难治性感染经验性根除方案和用药原则具有良好的根除疗效、安全性和依从性。Objective To evaluate the effectiveness of empiric eradication therapy recommendations and medication principles for refractory infections based on the 2022 Helicobacter pylori(H.pylori)infection treatment guidelines in China in clinical practice.Methods A retrospective analysis was conducted to evaluate the eradication efficacy of H.pylori and the safety and treatment compliance among of 637 patients with refractory H.pylori infection in our center over the past 10 years.Risk factors affecting efficacy of H.pylori eradication were evaluated.Results The overall eradication rate,incidence of adverse reactions and medication percentage of 14-day bismuth quadruple therapy were 92.3%,40.3% and 92.2%,respectively.The eradication rate,incidence of adverse reactions,and proportion of administered treatments were as follows:87.3%,36.4% and 92.7% for amoxicillin+metronidazole;91.1%,39.2% and 93.7% for amoxicillin+tetracycline;92.9%,23.8%and 94.0% for amoxicillin+furazolidone;92.1%,47.1% and 90.0% for tetracycline+metronidazole;94.5%,41.7% and 92.0% for tetracycline+furazolidone,and 91.3%,46.3% and 92.5% for furazolidone+metronidazole.Poor compliance was a risk factor for the failure of eradication therapy(94.7%vs.64.0%,P<0.05).There was no statistically significant difference(P>0.05)in the eradication rate among patients in terms of sex,age,body mass index,smoking status,alcohol consumption,previous eradication frequency,eradication interval,or eradication regimens.Conclusion The empirical treatment regimens and medication principles recommended in the 2022 H.pylori infection treatment guidelines in China achieve good eradication efficacy,safety,and compliance.

关 键 词：幽门螺杆菌 难治性 治疗 安全性 

分 类 号：R573[医药卫生—消化系统]