Cerqueira Rute M, Correia Manuel R, Vilar Hélder, Manso M Conceição
Gastroenterology, Centro Hospitalar entre Douro e Vouga, Santa Maria Feira, Portugal.
Biostatistics, Faculty of Health Sciences, FP-ENAS, University Fernando Pessoa, Porto, Portugal.
Obes Surg. 2016 Jun;26(6):1163-6. doi: 10.1007/s11695-015-1920-3.
Our aim was to assess, in obese patients undergoing Roux-en Y gastric bypass surgery, the quadruple concomitant HP eradication rates at first line treatment as proposed by the Maastricht IV consensus in areas of high clarithromycin resistance rates-proton pump inhibitor bid, clarithromycin 500 mg bid, amoxicillin 1000 mg bid, and metronidazole 500 mg bid. This is a single center prospective study over a 3-year period. Endoscopy and HP assessment (by histology or C13 urea breath) were performed at baseline, and post treatment HP status was assessed by C13 urea breath test 4-6 weeks after the end of therapy.
The study cohort consisted of 600 adult obese HP positive patients [19 % male/81 % female, age 40.7 (±10.4) years] consecutively scheduled for HP concomitant therapy. HP was eradicated in 416 patients [69.3 % (95% CI 65.5-72.9 %)] and the eradication was independent of gender, age, endoscopic diagnosis, and smoking status (p > 0.05).
Two weeks quadruple concomitant therapy did not achieve Maastricht recommended first line acceptable HP eradication rates (at least 80 %) in obese Portuguese patients undergoing GB.
我们的目的是评估在克拉霉素耐药率较高地区接受Roux - en Y胃旁路手术的肥胖患者中，按照马斯特里赫特IV共识建议进行一线治疗时的四重联合根除幽门螺杆菌（HP）的比率——质子泵抑制剂每日两次，克拉霉素500毫克每日两次，阿莫西林1000毫克每日两次，甲硝唑500毫克每日两次。这是一项为期3年的单中心前瞻性研究。在基线时进行内镜检查和HP评估（通过组织学或C13尿素呼气试验），治疗结束后4 - 6周通过C13尿素呼气试验评估治疗后HP状态。
研究队列包括600例成年肥胖HP阳性患者[男性19%/女性81%，年龄40.7（±10.4）岁]，他们连续接受HP联合治疗。416例患者（69.3%[95%置信区间65.5 - 72.9%]）的HP被根除，根除情况与性别、年龄、内镜诊断和吸烟状况无关（p＞0.05）。
在接受胃旁路手术的肥胖葡萄牙患者中，为期两周的四重联合治疗未达到马斯特里赫特推荐的一线可接受的HP根除率（至少80%）。
