Tatsuta M, Ishikawa H, Iishi H, Okuda S, Yokota Y
Department of Gastrointestinal Oncology, Centre for Adult Diseases, Osaka, Japan.
Gut. 1990 Sep;31(9):973-6. doi: 10.1136/gut.31.9.973.
The effect on the recurrence of gastric ulcers after suppression of Helicobacter pylori by combined treatment with cimetidine and the antimicrobial drug cefixime was investigated. Twenty one of 43 patients with endoscopically proved gastric ulcer and H pylori infection were randomly assigned to receive cimetidine 800 mg daily for 12 weeks; the remaining 22 patients received cimetidine 800 mg daily for 12 weeks plus cefixime 100 mg daily for the last two weeks. After treatment, 88% of 17 patients on cimetidine only remained H pylori positive, whereas combined administration of cimetidine and cefixime had suppressed H pylori in 78% of 18 patients (p less than 0.05). Seventeen patients in the former group whose ulcers healed but who remained H pylori positive and 18 patients in the latter group whose ulcers healed and who were no longer infected with H pylori continued to be followed after treatment. These patients underwent endoscopy to detect ulcer recurrence if symptomatic, or at 12 and 24 weeks if asymptomatic. At 12 weeks, recurrence was observed in seven of 15 (47%) patients in whom H pylori persisted, but in only one of 14 (7%) patients in whom H pylori had been suppressed (p less than 0.05). At 24 weeks, however, recurrence rates were similar between the two groups. These findings indicate that H pylori infection may be closely related to early ulcer recurrence.
研究了西咪替丁与抗菌药物头孢克肟联合治疗根除幽门螺杆菌后对胃溃疡复发的影响。43例经内镜证实为胃溃疡且感染幽门螺杆菌的患者中，21例被随机分配接受每日800mg西咪替丁治疗，疗程12周；其余22例患者接受每日800mg西咪替丁治疗12周，且在最后两周加用每日100mg头孢克肟。治疗后，仅接受西咪替丁治疗的17例患者中88%仍为幽门螺杆菌阳性，而联合使用西咪替丁和头孢克肟使18例患者中的78%幽门螺杆菌得到抑制（P<0.05）。前一组中溃疡愈合但仍为幽门螺杆菌阳性的17例患者和后一组中溃疡愈合且不再感染幽门螺杆菌的18例患者在治疗后继续接受随访。这些患者若出现症状则接受内镜检查以检测溃疡复发，若无症状则在12周和24周时接受内镜检查。12周时，幽门螺杆菌持续存在的15例患者中有7例（47%）出现复发，而幽门螺杆菌已被抑制的14例患者中仅1例（7%）复发（P<0.05）。然而，在24周时，两组的复发率相似。这些发现表明幽门螺杆菌感染可能与溃疡早期复发密切相关。
