10天与14天左氧氟沙星三联疗法补救治疗幽门螺杆菌感染的疗效比较

摘要

目的：比较两种不同疗程的左氧氟沙星三联疗法在幽门螺杆菌(Hp)补救治疗中的疗效和安全性。方法：将Hp感染根除治疗失败的115例患者随机分为A组(57例)和B组(58例)。两组患者均给给予含左氧氟沙星的三联疗法(左氧氟沙星+阿莫西林+埃索美拉唑镁肠溶片),A组疗程为10天,B组疗程为14天,治疗结束后4周做13C-尿素酶呼气试验,比较两组的Hp根除效果。结果：A组52例完成治疗及随访,其中42例补救治疗成功,其按意向治疗(ITT)Hp根除率和按符合方案(PP)Hp根除率分别为73.7%(42/57)和80.8%(42/52)；B组53例完成治疗及随访,44例补救治疗成功,其ITT根除率和PP根除率分别为75.9%(44/58)和83.0%(44/53),两组根除率比较差异无统计学意义(P>0.05)。结论：对既往Hp根除治疗失败的患者,10天与14天左氧氟沙星三联疗法根除率无明显差异,在补救治疗时可选用10天左氧氟沙星三联疗法。%Levofloxacin-based triple therapy can be suggested as the regimen of choice for rescue therapy in the eradication of Helicobacter pylori infection.The aim of this study was to compare the efficacy and tolerability of 10-day and 14-day levofloxacin-based triple therapy as an second-line treatment.Methods:A total of 115 patients, in whom the initial standard PPI triple therapy had failed to eradicate Helicobacter pylori infection,were included in the study.Patients were randomized to receive either 10-day (Group A:57 patients) or 14-day (Group B:58 patients) therapy with esomeprazole (20mg b.i.d.),plus levofloxacin (500mg q.d.) and amoxicillin (1000mg b.i.d.).Eradication was assessed by 13C-urea breath test four weeks after completing the treatment protocols. Results:The intention-to-treat (ITT) and per-protocol (PP) eradication rates were 73.7%and 80.8%in the 10-day levofloxacin-based triple therapy,and 75.9%and 83.0%in the 14-day therapy(P>0.05),respectively.Conclusion:Because the 10-day levofloxacin-based triple therapy is not inferior to the 14-day therapy,the 10-day regimen could be an effective option as rescue treatment for Helicobacter pylori infection.