幽门螺杆菌根除治疗效果分析

摘要

Objective To explore factors that affect the outcomes of Helicobacter pylori ( H. pylori ) eradication. Methods A total of 502 patients who were confirmed to be with H. pylori infection by Gastroscope urease and/or 13C - UBT in our hospital between January 2010 and September 2011 were enrolled in this study. The relevant data were collected and analyzed. Results The total eradication rate was 60. 76% , in which the eradication rate was 66. 67% ( 164/246 ) in males and 55. 08% ( 141/256 ) in females ( x2=7. 066, P <0. 05 ). The eradication rates showed no significant difference among different age groups ( P > 0. 05 ). Among the 9 therapeutic regimens, PPI + B + C + L achieved the highest eradication rate ( 80. 49% ), whereas PPI + B + L + Tin had the lowest one ( 50. 00% ) ( x2 = 7. 570, P < 0. 05 ). The Tin - based regimens had low eradication rates ( except PPI + A + Tin ). The eradication rate of PPI + B + ACL + Tin was 60. 78% , but it was not statistically different from PPI + ACL + Tin ( 55. 10% ) ( x2 = 0. 331, P >0. 05 ). About 63. 75% of the patients applied the 7 - day regimen, and the the eradication rate was 63. 44% , which was higher than other regimens. The eradication rates showed no statistical difference among different treatment cycles ( x =3. 294, P >0. 05 ). The esomeprazole group and omeprazole group had significantly different H. pylori eradication rates ( x =7. 839, P =0. 005 ). Conclusion The H. pylori eradication rate is related to gender, treatment scheme, and proton -pump inhibitors, but not to age and treatment cycle.%目的 从幽门螺杆菌(Helicobacter pylori,H.pylori)根治的疗效角度,探讨影响H.pylori治疗的可能因素,以期为临床合理用药提供依据.方法 对本院2010年1月-2011年9月经胃镜尿素酶检查和(或)13C-呼气试验检测H.pylori阳性患者的治疗情况进行随访,收集H.pylori治疗结果并进行统计、分析.结果 患者资料完整者共502例,H.pylori总体根除率为60.76%,其中男性根除率为66.67%(164/246),女性根除率为55.08%(141/256),不同性别H.pylori根除率比较,差异有统计学意义(χ2=7.066,P＜0.05).本研究分7个年龄段(未满18岁者未纳入年龄段统计),成年人各年龄段总体H.pylori根除率比较,差异无统计学意义(P＞0.05).本研究筛选出9种不同的H.pylori根治方案,其中以质子泵抑制剂(PPI)+铋剂(B)+克拉霉素(C)+左氧氟沙星(L)方案H.pylori根除率最高(为80.49%),PPI+B+L+替硝唑(Tin)的H.pylori根除率最低(为50.00%),两种方案H.pylori根除率比较,差异有统计学意义(χ2=7.570,P＜0.05);含Tin的H.pylori根除方案,除PPI+阿莫西林(A)+Tin方案外,H.pylori根除率偏低;PPI+阿莫西林双氯西林(ACL)+Tin方案H.pylori根除率为55.10%,与PPI+B+ACL+Tin方案的60.78%比较,差异无统计学意义(χ2=0.331,P＞0.05).7 d疗程方案者占63.75%,H.pylori根除率为63.44%,较其他疗程高,各疗程间H.pylori根除率比较,差异无统计学意义(χ2=3.294,P＞0.05).埃索美拉唑(Eso)与奥美拉唑(Ome)方案H.pylori根除率比较,差异有统计学意义(χ2=7.839,P=0.005,检验水准调整值为0.008).结论 H.pylori根除率与性别、治疗方案、PPI有关,与年龄、疗程无关.