Mera R, Realpe J L, Bravo L E, DeLany J P, Correa P
Stanley S. Scott Cancer Center, Louisiana State University Medical Center, New Orleans, USA.
J Clin Gastroenterol. 1999 Jul;29(1):51-5. doi: 10.1097/00004836-199907000-00013.
To study the effects of treatment of Helicobacter pylori infection in a hyperendemic population, 143 infected patients from the region of Nariño, Colombia, were treated for 2 weeks with clarithromycin (500 mg twice a day), amoxicillin (1 g twice a day), and either lansoprazole (30 mg twice a day) or omeprazole (30 mg twice a day). All patients belong to a low socioeconomic strata, had multifocal atrophic gastritis documented by gastric biopsies, and had been treated previously and unsuccessfully for 2 weeks with bismuth subsalicylate (262 mg four times a day), amoxicillin (500 mg three times a day), and metronidazole (400 mg three times a day). 13C-urea breath tests were performed 6, 12, 24, and 60 weeks after completing therapy. The 13C-urea breath test was negative in 79.7% of patients 1 month after finishing therapy, and in 69.2% of patients 1 year after finishing treatment. There were no differences in eradication rates between patients treated with omeprazole versus lansoprazole. Dyspepsia symptoms decreased from 74% in patients at baseline to 19% at the time of finishing treatment. In low-socioeconomic status populations with hyperendemic infection, triple therapy using omeprazole or lansoprazole plus clarithromycin and amoxicillin is an effective alternative when previous standard bismuth-based triple therapy has failed.
为研究在幽门螺杆菌高度流行人群中进行幽门螺杆菌感染治疗的效果，对来自哥伦比亚纳里尼奥地区的143名感染患者，采用克拉霉素（每日2次，每次500毫克）、阿莫西林（每日2次，每次1克），并联合兰索拉唑（每日2次，每次30毫克）或奥美拉唑（每日2次，每次30毫克）进行了为期2周的治疗。所有患者均属于社会经济地位较低阶层，经胃活检证实患有多灶性萎缩性胃炎，且此前曾接受次水杨酸铋（每日4次，每次262毫克）、阿莫西林（每日3次，每次500毫克）和甲硝唑（每日3次，每次400毫克）治疗2周，但未获成功。在完成治疗后的第6、12、24和60周进行了13C尿素呼气试验。治疗结束1个月后，79.7%的患者13C尿素呼气试验呈阴性，治疗结束1年后，69.2%的患者试验结果为阴性。使用奥美拉唑与使用兰索拉唑治疗的患者根除率无差异。消化不良症状从基线时患者中的74%降至治疗结束时的19%。在幽门螺杆菌高度流行的低社会经济地位人群中，当先前基于铋剂的标准三联疗法失败时，使用奥美拉唑或兰索拉唑联合克拉霉素和阿莫西林的三联疗法是一种有效的替代方案。
