Kawai Takashi, Kawakami Kohei, Mikinori Kataoka, Takei Kazuo, Itoi Takao, Moriyasu Fuminori, Takagi Yuu, Aoki Tatsuya, Watanebe Kiyoshi, Matsumoto Yuushuke, Rimbara Emiko, Noguchi Norihisa, Sasatsu Masanori
Endoscopy Center, Tokyo Medical University Hospital, Japan.
Hepatogastroenterology. 2007 Mar;54(74):649-54.
BACKGROUND/AIMS: In Japan, eradication regimens consisting of a proton pump inhibitor (PPI) + amoxicillin (AMPC) + clarithromycin (CAM) (PPI/AC) for 1 week have been conducted. In the present study, we assessed the eradication rates following treatment with low doses of various PPIs.
135 patients were divided randomly into one of three 7-day regimens: (i) omeprazole (OPZ) 20 mg/day + AMPC 1500 mg/day + CAM 600 mg/day (OAC); (ii) lansoprazole (LPZ) 30 mg + AMPC 1500 mg/day + CAM 600 mg/day (LAC); and (iii) rabeprazole (RPZ) 10mg/day + AMPC 1500 mg/ day + CAM 600 mg/day (RAC). The genetic polymorphism of CYP2C19 was also examined.
The eradication rates according to the treatment regimen were as follows: 69.9% (31/45) for OAC, 62.2% (28/45) for LAC, and 71.1% (32/45) for RPZ. No significant differences were found among the regimens. Moreover, eradication rates, according to CYP2C19 phenotype (homozygous extensive metabolizer (EM), heterozygous EM, and poor metabolizer) were: 68.6% (35/51), 77.4% (41/53), and 82.4% (14/17), respectively.
In PPI/AC therapy, the eradication rate for each low-dose PPI was 60-70%, which is low. Based on previous reports, it is considered that doses greater than 40 mg/day OPZ, 60 mg/day LPZ, and 20 mg/day RPZ are required.
背景/目的：在日本，已开展了为期1周的由质子泵抑制剂（PPI）+阿莫西林（AMPC）+克拉霉素（CAM）（PPI/AC）组成的根除方案。在本研究中，我们评估了使用低剂量各种PPI治疗后的根除率。
135例患者被随机分为三种7天治疗方案中的一种：（i）奥美拉唑（OPZ）20mg/天+AMPC 1500mg/天+CAM 600mg/天（OAC）；（ii）兰索拉唑（LPZ）30mg+AMPC 1500mg/天+CAM 600mg/天（LAC）；以及（iii）雷贝拉唑（RPZ）10mg/天+AMPC 1500mg/天+CAM 600mg/天（RAC）。还检测了CYP2C19的基因多态性。
根据治疗方案的根除率如下：OAC为69.9%（31/45），LAC为62.2%（28/45），RPZ为71.1%（32/45）。各方案之间未发现显著差异。此外，根据CYP2C19表型（纯合子广泛代谢型（EM）、杂合子EM和慢代谢型）的根除率分别为：68.6%（35/51）、77.4%（41/53）和82.4%（14/17）。
在PPI/AC治疗中，每种低剂量PPI的根除率为60 - 70%，较低。根据既往报道，认为需要大于40mg/天的OPZ、60mg/天的LPZ和20mg/天的RPZ剂量。
