西藏地区成人幽门螺杆菌不同根除方案疗效对比  

Efficacy Compared Among Different Eradication Regimens for Helicobacter Pylori in Adults in Xizang

作　　者：常梦茹 郭展鹏 次仁央金[2] Chang Mengru;Guo Zhanpeng;Ciren Yangjin(Schol of Medical,Xizang University,Lhasa 850000,China;Department of Gastroenterology,Xizang People's Hospital,Lhasa 850000,China)

机构地区：[1]西藏大学医学院,拉萨850000 [2]西藏自治区人民医院消化内科,拉萨850000

出　　处：《西藏科技》2025年第2期46-50,共5页Xizang Science And Technology

摘　　要：目的幽门螺杆菌(Helicobacter pylori,H.pylori)感染不仅与多种消化系统疾病的发生有着密不可分的关系。根除幽门螺杆菌可增加消化性溃疡治愈率、降低其复发率及并发症的发生率。西藏地区HP感染高于我国内地其他地区,且有关西藏地区H.pylori感染根除方案的的报道非常少。分析西藏地区H.pylori根除方案,为西藏地区H.pylori感染提出最佳根除治疗方案,对改善西藏地区患者的健康状况,预防胃癌等消化系统疾病的发生具有较好意义。方法回顾性分析2016年1月1日-2022年1月1日就诊于西藏自治区人民医院消化内科H.pylori阳性并治疗患者1015例,根据不同治疗方案分为A组,即经典四联方案,具体为铋剂+PPI(质子泵抑制剂+阿莫西林+克拉霉素),B组,PPI+丽珠维三联(铋剂+PPI+替硝唑+克拉霉素);C组,PPI+阿莫西林+克拉霉素,追踪其复查结果及治疗过程中出现的不良反应,比较不同根除方案对HP的根除率以及比较不同根除方案之间不良反应发生率,同时分析诊疗管理过程存在的问题。结果1015例HP阳性患者中,最终正规治疗并复查的患者有142例,406人未复查,467人失访,未复查原因主要为患者对疾病重视程度欠佳。142例复查患者中,最小年龄18岁,最大年龄66岁,平均年龄为38.04±11.48。女性占比30.3%,男性占比69.7%.A组根除方案的根除率为88.7%、B组根除率为70.0%、C组根除率为72.5%。三组根除方案A组与B组、A组与C组之间的差异有统计学意义(P<0.05);A组不良反应发生率为3.6%,B组不良反应发生率为8.8%,C组不良反应发生率为10.6%,三组根除方案之间不良反应发生率差异有统计学意义,P<0.05。结论三组不同根除方案之间A组即铋剂+PPI+阿莫西林+克拉霉素组根除率较高,且不良反应发生率较低,故临床上推荐使用方案A;同时发现临床上对于HP的根除治疗与患者依从性、医师的宣教及随访等密切相关。从卫生经济学Objective Helicobacter pylori(H.pylori)infection is closely linked to various digestive system diseases.Eradicating H.pylori can increase the cure rate of digestive ulcers,lower the recurrence rate,and reduce the occurrence of complications.The prevalence of H.pylori infection in Xizang is higher than other regions in China,and there is a scarcity of studies on eradication regimensfor this region.This study aims to analyze the H.pylori eradication regimens in Xizang and propose an optimal treatment regimen to improve the health of patients and prevent gastrointestinal diseases such as gastric cancer.Methods A retrospective analysis is performed on 1015 H.pyloripositive patients admitted to the Gastroenterology Department of Xizang People's Hospital of from January 1,2016 to January 1,2022,According to different treatment regimens,they were divided into group A,classical quadruple regimen,namely,bismuth+PPI(proton pump inhibitor+amoxicillin+clarithromycin),Group B,PPI+lizuvir triple(bismuth+PPI+tinidazole+clarithromycin),and group C,PPI+amoxicillin+clarithromycin.The reexamination results and adverse reactions occurred during treatment were tracked,and the eradication rate of Hp and incidence of adverse reactions among different eradication regimens were compared,and the problems existing in diagnosis and treatment management were analyzed.Results Among 1015 HP-positive patients,142 were formally treated and re-examined,406 were not re-examined,and 467 were lost to follow-up.The main reason for the non-re-examined patients was poor attention to the disease.Among the 142 reexamined patients,the youngest was 18,the oldest was 66 and the average age was 38.04±11.48.Female accounted for 30.3%,and male accounted for 69.7%.The eradication rate in Group A was 88.7%,Group B 70.0% and Group C 72.5%.The differences between group A and group B,group A and group C were statistically significant(P<0.05).The incidence of adverse reactions in group A was 3.6%,group B 8.8%,and group C 10.6%.There was a statistically significant

关 键 词：幽门螺杆菌 根除方案 根除率 不良反应 西藏 

分 类 号：R573[医药卫生—消化系统]