静脉注射奥美拉唑对消化性溃疡出血患者三联疗法根除幽门螺杆菌的影响。
Impact of intravenous omeprazole on Helicobacter pylori eradication by triple therapy in patients with peptic ulcer bleeding.
作者信息
Sheu B-S, Chi C-H, Huang C-C, Kao A-W, Wang Y-L, Yang H-B
机构信息
Department of Internal Medicine, National Cheng Kung University, Tainan, Taiwan.
出版信息
Aliment Pharmacol Ther. 2002 Jan;16(1):137-43. doi: 10.1046/j.1365-2036.2002.01137.x.
AIM
To test the impact of intravenous omeprazole on Helicobacter pylori eradication for bleeding peptic ulcers.
METHODS
A total of 175 H. pylori-infected patients with bleeding peptic ulcers were randomized into either an omeprazole group or a ranitidine group, receiving intravenous omeprazole or ranitidine for 3 days after endoscopy. Afterwards, 1-week triple therapy was used to eradicate H. pylori for both groups. Six weeks later, either a 13C-urea breath test or follow-up endoscopy was performed to assess the success of H. pylori eradication.
RESULTS
The rebleeding rate was lower in the omeprazole group vs. the ranitidine group (6% vs. 17%, P < 0.05). The H. pylori eradication rate was higher in the omeprazole group (intention-to-treat analysis: 83% vs. 66%, P < 0.05; per protocol analysis: 93% vs. 80%, P < 0.05). For patients with duodenal ulcers, the per protocol H. pylori eradication rate of the omeprazole group was higher than that of the ranitidine group (93% vs. 73%, P < 0.05).
CONCLUSIONS
Intravenous omeprazole can decrease the risk of rebleeding of peptic ulcers. For duodenal ulcers, in particular, intravenous omeprazole may even improve the H. pylori eradication rate of the subsequent triple therapy.
目的
测试静脉注射奥美拉唑对消化性溃疡出血患者幽门螺杆菌根除的影响。
方法
总共175例幽门螺杆菌感染的消化性溃疡出血患者被随机分为奥美拉唑组或雷尼替丁组，在内镜检查后接受3天的静脉注射奥美拉唑或雷尼替丁治疗。之后，两组均采用为期1周的三联疗法根除幽门螺杆菌。6周后，进行13C-尿素呼气试验或随访内镜检查以评估幽门螺杆菌根除是否成功。
结果
奥美拉唑组的再出血率低于雷尼替丁组（6% 对17%，P < 0.05）。奥美拉唑组的幽门螺杆菌根除率更高（意向性分析：83% 对66%，P < 0.05；符合方案分析：93% 对80%，P < 0.05）。对于十二指肠溃疡患者，奥美拉唑组符合方案的幽门螺杆菌根除率高于雷尼替丁组（93% 对73%，P < 0.05）。
结论
静脉注射奥美拉唑可降低消化性溃疡再出血的风险。特别是对于十二指肠溃疡，静脉注射奥美拉唑甚至可能提高后续三联疗法的幽门螺杆菌根除率。
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