Hong Jeana, Yang Hye Ran
Department of Pediatrics, Kangwon National University Hospital, Chuncheon, Korea. ; Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
Pediatr Gastroenterol Hepatol Nutr. 2012 Dec;15(4):237-42. doi: 10.5223/pghn.2012.15.4.237. Epub 2012 Dec 31.
The aim of this study was to assess and compare the efficacies of proton pump inhibitor-based triple therapy and bismuth-based quadruple therapy as first-line treatments for Helicobacter pylori eradication in Korean children.
We retrospectively reviewed the data of children who had been diagnosed with H. pylori infection at the Seoul National University Bundang Hospital from March 2004 to August 2012. The patients were randomly assigned to receive either triple therapy consisting of omeprazole, amoxicillin, and clarithromycin for 2 weeks (OAC group) or quadruple therapy comprising omeprazole, amoxicillin, metronidazole, and bismuth salts for 1 week (OAMB group). The patients were evaluated for eradication of H. pylori infection at 4 weeks after the completion of the treatment.
Of the 129 children enrolled in this study, 118 (91.5%) were included in the final analysis. The eradication rates in OAC and OAMB groups were 67.7% (42/62) and 83.9% (47/56), respectively, which were significantly different between the 2 treatment groups (p=0.041). The eradication rates in the OAMB group during the periods 2004-2006, 2007-2009, and 2010-2012 were superior to those in the OAC group.
This study indicated that the 1-week bismuth-based quadruple therapy, compared with the standard 2-week triple therapy, was significantly more successful in eradicating H. pylori infection in Korean children.
本研究旨在评估和比较以质子泵抑制剂为基础的三联疗法和以铋剂为基础的四联疗法作为韩国儿童幽门螺杆菌根除一线治疗方案的疗效。
我们回顾性分析了2004年3月至2012年8月在首尔国立大学盆唐医院被诊断为幽门螺杆菌感染的儿童数据。患者被随机分配接受由奥美拉唑、阿莫西林和克拉霉素组成的三联疗法,疗程为2周(OAC组),或由奥美拉唑、阿莫西林、甲硝唑和铋盐组成的四联疗法,疗程为1周(OAMB组)。在治疗结束后4周评估患者幽门螺杆菌感染的根除情况。
本研究纳入的129名儿童中,118名(91.5%)纳入最终分析。OAC组和OAMB组的根除率分别为67.7%(42/62)和83.9%(47/56),两组治疗效果有显著差异(p = 0.041)。2004 - 2006年、2007 - 2009年和2010 - 2012年期间,OAMB组的根除率均高于OAC组。
本研究表明,与标准的2周三联疗法相比,1周的以铋剂为基础的四联疗法在根除韩国儿童幽门螺杆菌感染方面显著更成功。