目的 探討含左氧氟沙星的三聯(lián)療法作為一線方案對(duì)幽門螺桿菌感染治療的有效性和安全性。 方法 選擇2008年9月-2011年3月125例確診為幽門螺桿菌感染的初治患者,隨機(jī)分為雷貝拉唑、阿莫西林聯(lián)合左氧氟沙星組(A組)和雷貝拉唑、阿莫西林聯(lián)合克拉霉素組(B組),經(jīng)治療7 d后比較兩組根除率和不良反應(yīng)發(fā)生率。 結(jié)果 A、B組幽門螺桿菌符合方案分析根除率分別為91.8%、77.6%,意向性治療根除率分別為88.9%、72.6%,A組根除率高于B組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。A、B組不良反應(yīng)發(fā)生率分別為4.8%、3.2%(P>0.05)。 結(jié)論 以左氧氟沙星、阿莫西林、雷貝拉唑?yàn)榻M合的三聯(lián)療法能顯著提高幽門螺桿菌感染的初治成功率,不良反應(yīng)少,安全有效。
引用本文: 譚禮讓,李虎,金軍,吳龍飛. 左氧氟沙星三聯(lián)療法根治幽門螺桿菌感染. 華西醫(yī)學(xué), 2012, 27(3): 329-331. doi: 復(fù)制
1. | 中華醫(yī)學(xué)會(huì)消化病學(xué)分會(huì)幽門螺桿菌學(xué)組. 第三次全國幽門螺桿菌感染若干問題共識(shí)報(bào)告(2007年8月·廬山)[J]. 中華內(nèi)科雜志, 2008, 47(4): 346-349. |
2. | Lind T, Veldhuyzen van Zanten S, Unge P, et al. Eradication of Helicobacter pylori using one-week triple therapies combining omeprazole with two antimicrobials: the MACH I Study[J]. Helicobacter, 1996, 1(3): 138-144. |
3. | 成虹, 胡伏蓮, 謝勇,等. 中國幽門螺桿菌耐藥狀況以及耐藥對(duì)治療的影響——全國多中心臨床研究[J]. 胃腸病學(xué), 2007, 12(9): 525-530. |
4. | Saad RJ, Schoenfeld P, Kim HM, et al. Levofloxacin-based triple therapy versus bismuth-based quadruple therapy for persistent Helicobacter pylori infection: a meta-analysis[J]. Am J Gastroenterol, 2006, 101(3): 488-496. |
5. | Gisbert JP, Morena F. Systematic review and meta-analysis: levofloxacin-based rescue regimens after Helicobacter pylori treatment failure[J]. Aliment Pharmacol Ther, 2006, 23(1): 35-44. |
6. | Malfertheiner P, Megraud F, O’Morain C, et al. Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report[J]. Gut, 2007, 56(6): 772-781. |
7. | 成虹, 胡伏蓮, 李江. 幽門螺桿菌耐藥性對(duì)其根除治療影響的研究[J]. 中華醫(yī)學(xué)雜志, 2006, 86(38): 2679-2682. |
8. | 牟方宏, 胡伏蓮 楊桂彬,等. 質(zhì)子泵抑制劑四聯(lián)療法作為幽門螺桿菌根除治療一線方案的臨床研究[J]. 胃腸病學(xué), 2007, 12(9): 531-534. |
9. | De Francesco V, Margiotta M, Zullo A, et al. Prevalence of primary clarithromycin resistance in Helicobacter pylori strains over a 15 year period in Italy[J]. J Antimicrob Chemother, 2007, 59(4): 783-785. |
10. | Mégraud F. H pylori antibiotic resistance: prevalence, importance, and advances in testing[J]. Gut, 2004, 53(9): 1374-1384. |
11. | Mégraud F. Update on Therapeutic Options for Helicobacter Pylori-related Diseases[J]. Curr Infect Dis Rep, 2005, 7(2): 115-120. |
12. | 鄒軍, 楊昭徐, 覃卓明. 左旋氧氟沙星抗幽門螺桿菌的實(shí)驗(yàn)室評(píng)價(jià)和臨床研究[J]. 中華醫(yī)學(xué)雜志, 2003, 83(20): 178-181. |
13. | 袁媛, 于靜, 賈長河. 含左氧氟沙星的一線方案根除幽門螺桿菌療效分析[J]. 山東醫(yī)藥, 2009, 49(52): 96-97. |
14. | Cammarota G, Cianci R, Cannizzaro O, et al. Efficacy of two one-week rabeprazole/levofloxacin-based triple therapies for Helicobacter pylori infection[J]. Aliment Pharmacol Ther, 2000, 14(10): 1339-1343. |
15. | Di Caro S, Zocco MA, Cremonini F, et al. Levofloxacin based regimens for the eradication of Helicobacter pylori[J]. Eur J Gastroenterol Hepatol, 2002, 14(12): 1309-1312. |
16. | Graham DY, Lu H, Yamaoka Y. A report card to grade Helicobacter pylori therapy[J]. Helicobacter, 2007, 12(4): 275-278. |
17. | 成虹, 胡伏蓮, 張國新, 等. 含左氧氟沙星三聯(lián)療法一線治療幽門螺桿菌感染: 多中心隨機(jī)對(duì)照臨床研究[J]. 中華醫(yī)學(xué)雜志, 2010, 90(2): 79-82. |
18. | 李虎, 譚禮讓, 何濱岑, 等. 含鉍劑四聯(lián)療法作為一線方案根治幽門螺桿菌感染的臨床研究[J]. 華西醫(yī)學(xué), 2011, 26(10): 1488-1490. |
- 1. 中華醫(yī)學(xué)會(huì)消化病學(xué)分會(huì)幽門螺桿菌學(xué)組. 第三次全國幽門螺桿菌感染若干問題共識(shí)報(bào)告(2007年8月·廬山)[J]. 中華內(nèi)科雜志, 2008, 47(4): 346-349.
- 2. Lind T, Veldhuyzen van Zanten S, Unge P, et al. Eradication of Helicobacter pylori using one-week triple therapies combining omeprazole with two antimicrobials: the MACH I Study[J]. Helicobacter, 1996, 1(3): 138-144.
- 3. 成虹, 胡伏蓮, 謝勇,等. 中國幽門螺桿菌耐藥狀況以及耐藥對(duì)治療的影響——全國多中心臨床研究[J]. 胃腸病學(xué), 2007, 12(9): 525-530.
- 4. Saad RJ, Schoenfeld P, Kim HM, et al. Levofloxacin-based triple therapy versus bismuth-based quadruple therapy for persistent Helicobacter pylori infection: a meta-analysis[J]. Am J Gastroenterol, 2006, 101(3): 488-496.
- 5. Gisbert JP, Morena F. Systematic review and meta-analysis: levofloxacin-based rescue regimens after Helicobacter pylori treatment failure[J]. Aliment Pharmacol Ther, 2006, 23(1): 35-44.
- 6. Malfertheiner P, Megraud F, O’Morain C, et al. Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report[J]. Gut, 2007, 56(6): 772-781.
- 7. 成虹, 胡伏蓮, 李江. 幽門螺桿菌耐藥性對(duì)其根除治療影響的研究[J]. 中華醫(yī)學(xué)雜志, 2006, 86(38): 2679-2682.
- 8. 牟方宏, 胡伏蓮 楊桂彬,等. 質(zhì)子泵抑制劑四聯(lián)療法作為幽門螺桿菌根除治療一線方案的臨床研究[J]. 胃腸病學(xué), 2007, 12(9): 531-534.
- 9. De Francesco V, Margiotta M, Zullo A, et al. Prevalence of primary clarithromycin resistance in Helicobacter pylori strains over a 15 year period in Italy[J]. J Antimicrob Chemother, 2007, 59(4): 783-785.
- 10. Mégraud F. H pylori antibiotic resistance: prevalence, importance, and advances in testing[J]. Gut, 2004, 53(9): 1374-1384.
- 11. Mégraud F. Update on Therapeutic Options for Helicobacter Pylori-related Diseases[J]. Curr Infect Dis Rep, 2005, 7(2): 115-120.
- 12. 鄒軍, 楊昭徐, 覃卓明. 左旋氧氟沙星抗幽門螺桿菌的實(shí)驗(yàn)室評(píng)價(jià)和臨床研究[J]. 中華醫(yī)學(xué)雜志, 2003, 83(20): 178-181.
- 13. 袁媛, 于靜, 賈長河. 含左氧氟沙星的一線方案根除幽門螺桿菌療效分析[J]. 山東醫(yī)藥, 2009, 49(52): 96-97.
- 14. Cammarota G, Cianci R, Cannizzaro O, et al. Efficacy of two one-week rabeprazole/levofloxacin-based triple therapies for Helicobacter pylori infection[J]. Aliment Pharmacol Ther, 2000, 14(10): 1339-1343.
- 15. Di Caro S, Zocco MA, Cremonini F, et al. Levofloxacin based regimens for the eradication of Helicobacter pylori[J]. Eur J Gastroenterol Hepatol, 2002, 14(12): 1309-1312.
- 16. Graham DY, Lu H, Yamaoka Y. A report card to grade Helicobacter pylori therapy[J]. Helicobacter, 2007, 12(4): 275-278.
- 17. 成虹, 胡伏蓮, 張國新, 等. 含左氧氟沙星三聯(lián)療法一線治療幽門螺桿菌感染: 多中心隨機(jī)對(duì)照臨床研究[J]. 中華醫(yī)學(xué)雜志, 2010, 90(2): 79-82.
- 18. 李虎, 譚禮讓, 何濱岑, 等. 含鉍劑四聯(lián)療法作為一線方案根治幽門螺桿菌感染的臨床研究[J]. 華西醫(yī)學(xué), 2011, 26(10): 1488-1490.