Department of Gastroenterology and Hepatology, Shinko Hospital, 1-4-47 Wakihama-cho, Chuo-ku, Kobe, Hyogo 651-0072, Japan.
World J Gastroenterol. 2010 Sep 7;16(33):4176-9. doi: 10.3748/wjg.v16.i33.4176.
To determine the general risk factors affecting the failure rate of first-line eradication therapy in Japanese patients with Helicobacter pylori (H. pylori) infection.
The present study enrolled 253 patients who had an H. pylori infection, underwent gastro-endoscopy, and were treated with H. pylori eradication therapy. Eradication therapy consisted of 30 mg lansoprazole plus 750 mg amoxicillin and 400 mg clarithromycin twice daily for 7 d. All of the patients underwent a 13C urea breath test at least 1 mo after the completion of eradication therapy. The current study investigated the independent factors associated with successful H. pylori eradication using a multiple logistic regression analysis.
The overall success rate in the patients was 85.8%. Among the general factors examined in the multivariate analyses, only having an age less than 50 years was found to be significantly associated with a poor response to H. pylori eradication. Moreover, side effects were the only clinical factors in the patients who were under 50 years of age that significantly influenced the poor response to H. pylori eradication.
H. pylori-positive elderly patients should undergo eradication therapy. In addition, it is necessary to improve H. pylori eradication therapy in younger patients.
确定影响日本幽门螺杆菌（H. pylori）感染患者一线根除治疗失败率的一般危险因素。
本研究纳入了 253 例 H. pylori 感染患者，这些患者接受了胃镜检查，并接受了 H. pylori 根除治疗。根除治疗包括每日 2 次口服 30mg 兰索拉唑、750mg 阿莫西林和 400mg 克拉霉素，共 7d。所有患者在根除治疗结束后至少 1 个月均进行了 13C 尿素呼气试验。本研究采用多因素逻辑回归分析，探讨与 H. pylori 根除成功相关的独立因素。
患者的总体成功率为 85.8%。在多因素分析中，仅年龄<50 岁被认为与 H. pylori 根除不良反应显著相关。此外，在年龄<50 岁的患者中，只有不良反应是影响 H. pylori 根除不良反应的显著临床因素。
H. pylori 阳性的老年患者应接受根除治疗。此外，有必要改善年轻患者的 H. pylori 根除治疗。
