在土耳其，幽门螺杆菌三联7至14天疗法和四联疗法的根除率较低。
Low eradication rate of Helicobacter pylori with triple 7-14 days and quadriple therapy in Turkey.
作者信息
Gumurdulu Yuksel, Serin Ender, Ozer Birol, Kayaselcuk Fazilet, Ozsahin Kursat, Cosar Arif Mansur, Gursoy Murat, Gur Gurden, Yilmaz Ugur, Boyacioglu Sedat
机构信息
Baskent Universitesi Tip Fakultesi, Adana Uygulama ve Arastirma Merkezi, Dadaloğlu Mahallesi, 39 Sokak, No: 6, 01250 Adana, Turkey.
出版信息
World J Gastroenterol. 2004 Mar 1;10(5):668-71. doi: 10.3748/wjg.v10.i5.668.
AIM
The eradication rate of Helicobacter pylori (H pylori) shows variation among countries and regimens of treatment. We aimed to study the eradication rates of different regimens in our region and some factors affecting the rate of eradication.
METHODS
One hundred and sixty-four H pylori positive patients (68 males, 96 females; mean age: 48+/-12 years) with duodenal or gastric ulcer without a smoking history were included in the study. The patients were divided into three groups according to the treatment regimens. Omeprazole 20 mg, clarithromycin 500 mg, amoxicillin 1 g were given twice daily for 1 week (Group I) and 2 weeks (Group II). Patients in Group III received bismuth subsitrate 300 mg, tetracyline 500 mg and metronidazole 500 mg four times daily in addition to Omeprazole 20 mg twice daily. Two biopsies each before and after treatment were obtained from antrum and corpus, and histopathologically evaluated. Eradication was assumed to be successful if no H pylorus was detected from four biopsy specimens taken after treatment. The effects of factors like age, sex, H pylori density on antrum and corpus before treatment, the total H pylori density, and the inflammation scores on the rate of H pylori eradication were evaluated.
RESULTS
The overall eradication rate was 42%. The rates in groups II and III were statistically higher than that in group I (P<0.05). The rates of eradication were 24.5%, 40.7% and 61.5% in groups I, II and III, respectively. The eradication rate was negatively related to either corpus H pylori density or total H pylori density (P<0.05). The median age was older in the group in which the eradication failed in comparison to that with successful eradication (55 yr vs 39 yr, P<0.001). No correlation between sex and H pylori eradication was found.
CONCLUSION
Our rates of eradication were significantly lower when compared to those reported in literature. We believe that advanced age and high H pylori density are negative predictive factors for the rate of H pylori eradication.
目的
幽门螺杆菌（H pylori）的根除率在不同国家和治疗方案之间存在差异。我们旨在研究本地区不同治疗方案的根除率以及一些影响根除率的因素。
方法
本研究纳入了164例幽门螺杆菌阳性患者（男性68例，女性96例；平均年龄：48±12岁），这些患者患有十二指肠或胃溃疡且无吸烟史。根据治疗方案将患者分为三组。第一组给予奥美拉唑20毫克、克拉霉素500毫克、阿莫西林1克，每日两次，共1周；第二组给予同样药物，疗程为2周。第三组患者除每日两次给予奥美拉唑20毫克外，还给予枸橼酸铋钾300毫克、四环素500毫克和甲硝唑500毫克，每日四次。治疗前后分别从胃窦和胃体各取两块活检组织，进行组织病理学评估。如果治疗后采集的四块活检标本中未检测到幽门螺杆菌，则认为根除成功。评估了年龄、性别、治疗前胃窦和胃体的幽门螺杆菌密度、幽门螺杆菌总密度以及炎症评分等因素对幽门螺杆菌根除率的影响。
结果
总体根除率为42%。第二组和第三组的根除率在统计学上高于第一组（P<0.05）。第一组、第二组和第三组的根除率分别为24.5%、40.7%和61.5%。根除率与胃体幽门螺杆菌密度或幽门螺杆菌总密度呈负相关（P<0.05）。根除失败组的中位年龄高于根除成功组（55岁对39岁，P<0.001）。未发现性别与幽门螺杆菌根除之间存在相关性。
结论
与文献报道的根除率相比，我们的根除率显著较低。我们认为高龄和高幽门螺杆菌密度是幽门螺杆菌根除率的负性预测因素。
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