Tam Y H, Yeung C K, Lee K H
Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
Aliment Pharmacol Ther. 2006 Jul 1;24(1):81-6. doi: 10.1111/j.1365-2036.2006.02969.x.
Helicobacter pylori infection is common in paediatric population. To date, there is still no universally accepted recommendation on the treatment of this infection in children. Ranitidine bismuth citrate-based triple therapy has been shown to be effective in H. pylori eradication in adults but its use has rarely been validated in children.
To investigate the efficacy of ranitidine bismuth citrate-based triple therapy in eradication of H. pylori in children and to determine the shortest duration of treatment required.
We conducted a prospective randomized study comparing ranitidine bismuth citrate plus amoxicillin plus clarithromycin given for 4 days vs. 7 days in H. pylori-infected children diagnosed by (13)C-urea breath test. Eradication was evaluated by repeat (13)C-urea breath test at 6 weeks after treatment.
A total of 206 children were recruited (median age 12 years, 97 boys and 109 girls). Ninety-eight (47.6%) and 108 (52.4%) children were randomized to receive 7-day and 4-day regimen respectively. The eradication rate of 4-day treatment arm was 77.8% (both intention-to-treat and per protocol) compared with 88.8% (intention-to-treat, P = 0.036) and 89.7% (per protocol, P = 0.022) of 7-day regimen. There was no statistical difference in terms of side effects between the two groups.
Seven-day ranitidine bismuth citrate-based triple therapy is an effective and well-tolerated treatment for eradication of H. pylori in children.
幽门螺杆菌感染在儿童群体中很常见。迄今为止，对于儿童幽门螺杆菌感染的治疗仍没有普遍接受的推荐方案。基于枸橼酸铋雷尼替丁的三联疗法已被证明对成人幽门螺杆菌根除有效，但在儿童中的应用很少得到验证。
研究基于枸橼酸铋雷尼替丁的三联疗法根除儿童幽门螺杆菌的疗效，并确定所需的最短治疗疗程。
我们进行了一项前瞻性随机研究，比较了在经（13）C - 尿素呼气试验诊断为幽门螺杆菌感染的儿童中，给予枸橼酸铋雷尼替丁加阿莫西林加克拉霉素治疗4天与7天的效果。治疗6周后通过重复（13）C - 尿素呼气试验评估根除情况。
共招募了206名儿童（中位年龄12岁，97名男孩和109名女孩）。98名（47.6%）和108名（52.4%）儿童分别被随机分配接受7天和4天的治疗方案。4天治疗组的根除率为77.8%（意向性分析和符合方案分析），而7天治疗方案的根除率分别为88.8%（意向性分析，P = 0.036）和89.7%（符合方案分析，P = 0.022）。两组之间在副作用方面没有统计学差异。
基于枸橼酸铋雷尼替丁的7天三联疗法是根除儿童幽门螺杆菌的一种有效且耐受性良好的治疗方法。
