【摘要】 目的 分析總結(jié)雷貝拉唑、阿莫西林、克拉霉素、替硝唑組成的10日序貫療法根除初治失敗幽門螺桿菌（Helicobacter pylori，Hp）的療效。 方法 將2009年5月-2011年5月在消化科門診及住院經(jīng)胃鏡確診的胃、十二指腸潰瘍患者65例，經(jīng)標(biāo)準(zhǔn)三聯(lián)療法治療4周后Hp仍陽(yáng)性的患者隨機(jī)分為兩組，治療組33例前5 d用雷貝拉唑10 mg、阿莫西林1.0，每日2次口服，后5 d用雷貝拉唑10 mg、克拉霉素500 mg、替硝唑500 mg，每日2次口服；對(duì)照組32例用雷貝拉唑10 mg、枸櫞酸鉍鉀600 mg、呋喃唑酮0.1 g、阿莫西林1.0 g，每日2次，療程10 d。停藥4周后復(fù)查Hp。 結(jié)果 治療組Hp根除率81.8%，對(duì)照組75.0%，兩組比較無(wú)統(tǒng)計(jì)學(xué)意義（P gt;0.05）。不良反應(yīng)率分別為12.1%和34.3%，兩組比較有統(tǒng)計(jì)學(xué)意義（P lt;0.05）。 結(jié)論 序貫療法對(duì)初治失敗Hp根除率高于四聯(lián)療法但無(wú)統(tǒng)計(jì)學(xué)意義，不良反應(yīng)率低于對(duì)照組，可作為根除初治失敗Hp的一種有效方案。
引用本文： 黃忠,李智,侯聰. 序貫療法根除初治失敗幽門螺桿菌療效觀察. 華西醫(yī)學(xué), 2011, 26(10): 1539-1540. doi: 復(fù)制
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- 1. Graham DY, Shiotani A. New concepts of resistance in the treatment of Helicobacter pylori infections [J].Nat Clin Pract Gastroenterol Hepatol, 2008, 5(6): 321-331.
- 2. Zullo A, Gatta L, De Francesco V, et al. High rate of Helicobacter pylori eradication with sequential therapy in elderly patients with peptic ulcer:a prospective controlled study[J].Aliment pharmacol Ther, 2005, 21(12): 1419-1424.
- 3. Francavilla R, Lionetti E, Castellaneta SP, et al. Improved efficacy of 10-Day sequential treatment for Helicobacter pylori eradication in children:a randomized trial[J]. Gastroenterology, 2005, 129(5): 1414-1419.
- 4. Bago P, Vcer A, Tomic M, et al. High eradication rate of H.pylori with moxifloxacin-based treatment:a randomized controlled trial[J].Wien Klin Wochenschr, 2007, 119(11-12): 372-378.
- 5. De Francesco V, Margiotta M, Zullo A, et al. Clarithromycin-resistant genotypes and eradication of Helicobacter pylori[J]. Ann Inter Med, 2006, 144(2): 94-100.
- 6. De Rossi E, Aínsa JA, Riccardi G. Role of mycobacterial efflux transporters in drug resistance:an unresolved question[J]. FEMS Microbiol Rev, 2006, 30(1):36-52.
- 7. Zechini B, Versace I. Inhibitiors of multidrug resistant efflux systems in bacteria[J]. Recent Pat Antiinfect Drug Discov, 2009, 4(1): 37-50.
- 8. Lomovskaya O, Bostian KA. Practical applications and feasibility of efflux pump inhibitors in the clinic-A vision for applied use[J]. Biochen Pharmacol, 2006, 71(7): 910-918.
- 9. Hong EJ, Park DI, Oh SJ, et al. Comparison of Helicobacter pylori eradication rate in patients with non-ulcer dyspepsia and peptic ulcer diseases according to proton pump inhibitors[J].Korean J Gastroenterol, 2008, 52(2): 80-85.
- 10. Aeschlimann JR, Dresser LD, Kaatz GW, et al. Effects of NorA in-hibitors on in vitro antibacterial activities and postantibiotic effects of levofloxacin, ciprofloxacin,and norfloxacin in genetically related strains of staphylococcus aurens[J]. Antimicrob Agents Chemother, 1999, 43(2): 335-340.