Makhlough Atieh, Fakheri Hafez, Hojati Samaneh, Hosseini Vahid, Bari Zohreh
Associate Professor, Department of Nephrology, Gut and Liver Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
Professor, Department of Gastroenterology, Gut and Liver Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
Middle East J Dig Dis. 2016 Jan;8(1):39-43. doi: 10.15171/mejdd.2016.05.
BACKGROUND The prevalence of peptic ulcer disease in hemodialysis patients is more than the general population. They are also more prone to complications including upper gastrointestinal bleeding. The aim of this study was to compare the efficacy of 14 days hybrid regimen with 14 days triple therapy for Helicobacter pylori (H. pylori ) eradication in hemodialysis patients. METHODS Forty hemodialysis patients with naïve H.pylori infection were randomized to receive either hybrid regimen (pantoprazole 40 mg + amoxicillin 500 mg, both twice a day during the first 7 days, followed by pantoprazole 40 mg + amoxicillin 500 mg + clarithromycin 500 mg + tinidazole 500 mg, all twice a day, for the second 7 days, or standard triple therapy including pantoprazole 40 mg, clarithromycin 500 mg, and amoxicillin 500 mg, all twice a day for 14 days. H.pylori eradication was assessed by fecal H.pylori antigen test 8 weeks after the treatment. RESULTS All the patients completed the study. According to both intention to treat and per-protocol analyses, H.pylori eradication rates were 100% (95% confidence interval (CI): 100) in those who received hybrid therapy and 70% (95% CI: 69.4 - 70.8) in those who were treated by standard triple therapy (p=0.02). Severe adverse effects were not reported by any patient; however, mild adverse effects were more frequent in those who received standard triple therapy (p<0.05). CONCLUSION Hybrid regimen could achieve ideal H.pylori eradication rates with low rates of adverse effects.
消化性溃疡疾病在血液透析患者中的患病率高于普通人群。他们也更容易出现包括上消化道出血在内的并发症。本研究的目的是比较14天混合疗法与14天三联疗法在血液透析患者中根除幽门螺杆菌（H. pylori）的疗效。方法：40例初发H. pylori感染的血液透析患者被随机分为接受混合疗法（泮托拉唑40 mg + 阿莫西林500 mg，均在第1个7天每天2次，随后是泮托拉唑40 mg + 阿莫西林500 mg + 克拉霉素500 mg + 替硝唑500 mg，均在第2个7天每天2次）或标准三联疗法（泮托拉唑40 mg、克拉霉素500 mg和阿莫西林500 mg，均每天2次，共14天）。治疗8周后通过粪便H. pylori抗原检测评估H. pylori根除情况。结果：所有患者均完成研究。根据意向性分析和符合方案分析，接受混合疗法的患者H. pylori根除率为100%（95%置信区间（CI）：100），接受标准三联疗法的患者为70%（95% CI：69.4 - 70.8）（p = 0.02）。没有患者报告严重不良反应；然而，接受标准三联疗法的患者中轻度不良反应更常见（p < 0.05）。结论：混合疗法可实现理想的H. pylori根除率且不良反应发生率低。
