二线根除治疗幽门螺杆菌的延迟可能会增加根除失败的风险。

Delay of second-line eradication therapy for Helicobacter pylori can increase eradication failure.

机构信息

Division of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.

出版信息

J Gastroenterol Hepatol. 2013 Oct;28(10):1608-10. doi: 10.1111/jgh.12281.

DOI:10.1111/jgh.12281

PMID:23701705

Abstract

BACKGROUND AND AIM

The interval between first-line Helicobacter pylori eradication treatment and second-line treatment may be critical to the second-line therapeutic effect. We attempted to assess the association between the second-line eradication rates and the treatment interval.

METHODS

Data of patients, who were administered the second-line H. pylori eradication regimen at Tokyo Medical Center between 2008 and 2012, were reviewed.

RESULTS

Of the 148 patients enrolled, one patient dropped out. The eradication rates were 88.6% (intention-to-treat [ITT]) and 89.3% (per-protocol [PP]) for early eradication group (eradication interval < 180 days, patients number 132) and 68.8% (ITT and PP) for delayed eradication group (eradication interval ≥ 180 days, patients number 16). The eradication rate in the delayed eradication group was significantly lower than in the early eradication group (P = 0.027 [ITT] and 0.021 [PP]). The eradication interval in the subjects showing eradication failure (124.0 ± 96.8 days, patients number 19) was significantly longer than those showing successful eradication (85.8 ± 56.9 days, patients number 128, P = 0.008).

CONCLUSION

Our results suggest that the delay of second-line treatment should be avoided.

摘要

背景与目的

一线幽门螺杆菌根除治疗与二线治疗之间的间隔时间可能对二线治疗效果至关重要。我们试图评估二线根除率与治疗间隔之间的关系。

方法

回顾了 2008 年至 2012 年在东京医疗中心接受二线 H. pylori 根除方案治疗的患者数据。

结果

在 148 名入组患者中，1 名患者脱落。早期根除组（根除间隔<180 天，患者 132 例）的根除率分别为 88.6%（意向治疗[ITT]）和 89.3%（按方案[PP]），延迟根除组（根除间隔≥180 天，患者 16 例）的根除率分别为 68.8%（ITT 和 PP）。延迟根除组的根除率明显低于早期根除组（P=0.027[ITT]和 0.021[PP]）。根除失败患者（124.0±96.8 天，患者 19 例）的根除间隔明显长于根除成功患者（85.8±56.9 天，患者 128 例，P=0.008）。