Okai T, Ohtsubo K, Sakai J, Watanabe H, Motoo Y, Kawashima A, Sawabu N
Department of Internal Medicine and Medical Oncology, Cancer Research Institute, Kanazawa University, Japan.
Can J Gastroenterol. 2000 Oct;14(9):761-6. doi: 10.1155/2000/340942.
To clarify whether the depth of ulceration evaluated by endoscopic ultrasonography (EUS) influences a modified dual therapy with amoxicillin and lansoprazole for the treatment of Helicobacter pylori-positive patients with gastric ulcer.
Twenty-two consecutive cases of gastric ulcer (nine superficial ulcers and 13 deep ulcers) in H pylori-positive patients were studied. Ten of 22 patients received a two-week eradication therapy with amoxicillin 1500 mg/day, lansoprazole 30 mg/day and a new antiulcer agent with features in common with sucralfate, ecabet sodium, 2.0 g/day. They continued to receive the same doses of lansoprazole and ecabet sodium for the next six weeks. The other 12 patients received the same therapy except for those who underwent the four-week amoxicillin treatment. All patients underwent EUS both at the start of the study and eight weeks later. They then received ecabet sodium alone for the next six months as a maintenance therapy, followed by a six-month interval with no treatment. The final endoscopy was done one year after H pylori eradication therapy was completed to evaluate H pylori status and ulcer recurrence.
The rates of endoscopic healing and H pylori eradication in the nine patients with superficial ulcer were 100%, irrespective of the period of amoxicillin treatment. In contrast, the rates of endoscopic evidence of healing and H pylori eradication in the 13 patients with deep ulcer were different for each period of amoxicillin treatment; that is, the rates of reduction in ulcer determined by echo and H pylori eradication in the four patients treated with the two-week amoxicillin course were significantly lower (P=0.03) than those in the nine patients treated with the four-week course.
Ulcer depth is likely to influence the success of amoxicillin treatment for H pylori-positive patients with gastric ulcer.
明确经内镜超声检查（EUS）评估的溃疡深度是否会影响阿莫西林和兰索拉唑联合治疗幽门螺杆菌阳性胃溃疡患者的改良双联疗法。
对22例幽门螺杆菌阳性患者的连续胃溃疡病例（9例表浅溃疡和13例深溃疡）进行研究。22例患者中有10例接受了为期两周的根除治疗，服用阿莫西林1500毫克/天、兰索拉唑30毫克/天以及一种与硫糖铝具有共同特性的新型抗溃疡药物依卡倍特钠2.0克/天。在接下来的六周内，他们继续服用相同剂量的兰索拉唑和依卡倍特钠。另外12例患者接受相同治疗，但阿莫西林治疗时间为四周。所有患者在研究开始时和八周后均接受EUS检查。然后，他们在接下来的六个月中单独服用依卡倍特钠作为维持治疗，随后有六个月的无治疗间隔期。在完成幽门螺杆菌根除治疗一年后进行最终内镜检查，以评估幽门螺杆菌状态和溃疡复发情况。
9例表浅溃疡患者的内镜愈合率和幽门螺杆菌根除率均为100%，与阿莫西林治疗时长无关。相比之下，13例深溃疡患者在不同阿莫西林治疗时长下的内镜愈合证据率和幽门螺杆菌根除率有所不同；也就是说，接受两周阿莫西林疗程治疗的4例患者，其经超声测定的溃疡缩小率和幽门螺杆菌根除率显著低于（P=0.03）接受四周疗程治疗的9例患者。
溃疡深度可能会影响阿莫西林治疗幽门螺杆菌阳性胃溃疡患者的疗效。
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