Tsukada K, Miyazaki T, Katoh H, Masuda N, Ojima H, Fukai Y, Nakajima M, Manda R, Fukuchi M, Kuwano H, Tsukada O
Dept. of First Surgery, Gunma University School of Medicine, Ueda Kidney Clinic, Maebashi, Japan.
Scand J Gastroenterol. 2002 Nov;37(11):1265-8. doi: 10.1080/003655202761020524.
Triple therapy is accepted as the treatment of choice for Helicobacter pylori eradication, but there is no consensus on how long the therapy should be maintained in haemodialysis (HD(+)) patients. Our aims in this study were to evaluate the safety and efficacy of the 7-day triple therapy in HD(+) patients.
Forty-seven HD(+) and 55 HD(-) patients with dyspepsia underwent endoscopy. The prevalence of H. pylori was detected by Giemsa stain, followed by the urea breath test (UBT). H. pylori(+) patients were scheduled to undergo 7-day triple therapy and the success of eradication was investigated by UBT.
Forty-five (44%) patients were positive for H. pylori. Forty of them underwent triple therapy and 39 (98%) patients completed the treatment. Eradication was successful in 32 (82%) and unsuccessful in 7 (18%) patients. There was no significant difference between these groups in age, gender, endoscopic findings or HD, and only previous treatment was significant for eradication failure by univariate and multivariate logistic regression analysis. Side effects were observed in 2 (15%) of 13 HD(+) and 3 (11%) of 27 HD(-) patients, and one HD(-) patient had to stop medication because of severe nausea and vomiting. The eradication rate was 93% (28/30) in patients without previous treatment. The triple therapy was unsuccessful in 7 patients, and 4 of them again underwent 7-day triple therapy, but all resulted in failure.
Seven-day triple therapy is safe and effective for primary treatment of H. pylori infection in both HD(+) and HD(-) patients, but a new treatment is necessary for patients with previous treatment.
三联疗法被公认为根除幽门螺杆菌的首选治疗方法，但对于血液透析（HD(+)）患者应维持多长时间的治疗尚无共识。本研究的目的是评估HD(+)患者7天三联疗法的安全性和有效性。
47例HD(+)和55例HD(-)消化不良患者接受了内镜检查。通过吉姆萨染色检测幽门螺杆菌的患病率，随后进行尿素呼气试验（UBT）。幽门螺杆菌阳性患者计划接受7天三联疗法，并通过UBT调查根除成功率。
45例（44%）患者幽门螺杆菌呈阳性。其中40例接受了三联疗法，39例（98%）患者完成了治疗。32例（82%）患者根除成功，7例（18%）患者根除失败。这些组在年龄、性别、内镜检查结果或血液透析方面无显著差异，单因素和多因素逻辑回归分析显示，只有既往治疗对根除失败有显著影响。13例HD(+)患者中有2例（15%）和27例HD(-)患者中有3例（11%）出现副作用，1例HD(-)患者因严重恶心和呕吐不得不停药。未接受过既往治疗的患者根除率为93%（28/30）。7例患者三联疗法失败，其中4例再次接受7天三联疗法，但均失败。
7天三联疗法对HD(+)和HD(-)患者幽门螺杆菌感染的初始治疗是安全有效的，但既往接受过治疗的患者需要新的治疗方法。
