Kim Sung Eun, Park Moo In, Park Seun Ja, Moon Won, Kim Jae Hyun, Jung Kyoungwon, Kim Hae Koo, Lee Young Dal
Sung Eun Kim, Moo In Park, Seun Ja Park, Won Moon, Jae Hyun Kim, Kyoungwon Jung, Hae Koo Kim, Young Dal Lee, Department of Internal Medicine, Kosin University College of Medicine, Busan 49267, South Korea.
World J Gastroenterol. 2017 Feb 14;23(6):1059-1066. doi: 10.3748/wjg.v23.i6.1059.
To investigate (. ) eradication rates using second-line bismuth-containing quadruple therapy and to identify predictors of eradication failure.
This study included 636 patients who failed first-line triple therapy and received 7 d of bismuth-containing quadruple therapy between January 2005 and December 2015. We retrospectively demonstrated . eradication rates with respect to the year of therapy as well as demographic and clinical factors. . eradication was confirmed by a C-urea breath test or a rapid urease test at least 4 wk after the completion of bismuth-based quadruple therapy: proton pump inhibitor, metronidazole, bismuth, and tetracycline.
The overall eradication rates by intention-to-treat analysis and per-protocol analysis were 73.9% (95%CI: 70.1%-77.4%) and 94.5% (95%CI: 92.4%-96.5%), respectively. Annual eradication rates from 2005 to 2015 were 100.0%, 92.9%, 100.0%, 100.0%, 100.0%, 97.4%, 100.0%, 93.8%, 84.4%, 98.9%, and 92.5%, respectively, by per-protocol analysis. A multivariate analysis showed that diabetes mellitus (OR = 3.99, 95%CI: 1.56-10.20, = 0.004) was associated with . eradication therapy failure.
The second-line bismuth-containing quadruple therapy for . infection is still effective in Korea, and diabetes mellitus is suggested to be a risk factor for eradication failure.
探讨使用含铋剂的二线四联疗法根除（.）的根除率，并确定根除失败的预测因素。
本研究纳入了636例一线三联疗法失败且在2005年1月至2015年12月期间接受了7天含铋剂四联疗法的患者。我们回顾性分析了治疗年份以及人口统计学和临床因素的（.）根除率。在基于铋剂的四联疗法（质子泵抑制剂、甲硝唑、铋剂和四环素）完成至少4周后，通过C-尿素呼气试验或快速尿素酶试验确认（.）根除情况。
意向性分析和符合方案分析的总体根除率分别为73.9%（95%CI：70.1%-77.4%）和94.5%（95%CI：92.4%-96.5%）。2005年至2015年按符合方案分析的年度根除率分别为100.0%、92.9%、100.0%、100.0%、100.0%、97.4%、100.0%、93.8%、84.4%、98.9%和92.5%。多因素分析显示，糖尿病（OR = 3.99，95%CI：1.56-10.20，P = 0.004）与（.）根除治疗失败相关。
在韩国，含铋剂的二线四联疗法用于（.）感染仍然有效，且糖尿病被认为是根除失败的一个危险因素。
