Georgopoulos S D, Ladas S D, Karatapanis S, Mentis A, Spiliadi C, Artikis V, Raptis S A
Second Department of Internal Medicine, Athens University, Evangelismos Hospital, Greece.
Dig Dis Sci. 2000 Jan;45(1):63-7. doi: 10.1023/a:1005405209503.
Factors affecting Helicobacter pylori eradication rate with omeprazole (OME), clarithromycin (CL), and amoxicillin (AMO) have not been extensively studied. We have investigated the effect of age, sex, smoking, ulcer disease, compliance with therapy, H. pylori colonization density, degree and activity of antral gastritis, the coexistence of corpus gastritis, and the presence of lymphoid follicles on H. pylori eradication rate. We studied 80 consecutive H. pylori-positive patients, with duodenal ulcer (N = 35) or nonulcer dyspepsia (N = 45) treated with OME 20 mg, CL 500 mg, and AMO 1 g, each given twice daily for 10 days. H. pylori was eradicated in 71/80 (88.8%, 95% CI 82-96%) patients. The regimen failed to eradicate the only strain (1.8%, 95% CI 0-5.2%) that was clarithromycin resistant. Multivariate discriminant analysis showed that two histological variables (Wilks lambda = 0.74, chi2 = 23.41, df = 2, P< 0.001), absence of lymphoid follicles in routine gastric biopsies (F = 13.63, P<0.001) and coexistence of antral and body gastritis (F = 13.68, P<0.001), significantly increased H. pylori eradication rate. No other factor examined predicted H. pylori eradication with this regimen. Our data suggest that body gastritis is a positive and presence of lymphoid follicles in routine gastric biopsies is a negative predictive factor of treatment outcome with the omeprazole, clarithromycin, and amoxicillin regime.
影响奥美拉唑（OME）、克拉霉素（CL）和阿莫西林（AMO）根除幽门螺杆菌率的因素尚未得到广泛研究。我们调查了年龄、性别、吸烟、溃疡病、治疗依从性、幽门螺杆菌定植密度、胃窦炎的程度和活动度、胃体炎的并存情况以及淋巴滤泡的存在对幽门螺杆菌根除率的影响。我们研究了80例连续的幽门螺杆菌阳性患者，其中十二指肠溃疡患者（N = 35）或非溃疡性消化不良患者（N = 45）接受OME 20 mg、CL 500 mg和AMO 1 g治疗，均每日两次，共10天。80例患者中有71例（88.8%，95%可信区间82 - 96%）幽门螺杆菌被根除。该方案未能根除唯一一株对克拉霉素耐药的菌株（1.8%，95%可信区间0 - 5.2%）。多变量判别分析显示，两个组织学变量（威尔克斯λ = 0.74，χ2 = 23.41，自由度 = 2，P < 0.001），即常规胃活检中无淋巴滤泡（F = 13.63，P < 0.001）和胃窦炎与胃体炎并存（F = 13.68，P < 0.001），显著提高了幽门螺杆菌根除率。所检查的其他因素均不能预测该方案根除幽门螺杆菌的情况。我们的数据表明，胃体炎是奥美拉唑、克拉霉素和阿莫西林方案治疗结果的阳性预测因素，而常规胃活检中淋巴滤泡的存在是阴性预测因素。
