Abakus Medico, Diagnostic Center Rogaška, Rogaška Slatina, Slovenia,
Diagnostic Center Bled, Bled, Slovenia.
Dig Dis. 2021;39(4):318-324. doi: 10.1159/000512506. Epub 2020 Oct 23.
Helicobacter pylori (H. pylori) is the most common chronic bacterial infection in the world, affecting over 50% of the world's population. H. pylori is a grade I carcinogen, responsible for the development of 89% of noncardia gastric cancers. In the present study, we analyzed the data for H. pylori eradication treatments in Slovenia after the 3rd national recommendations were implemented.
Slovenia is part of the European Registry on H. pylori Management since the Registry was launched in 2013. Data were collected at Asociación Española de Gastroenterología-Research Electronic Data Capture electronic case report form from September 2017 to December 2019. H. pylori eradication treatment was assessed by modified intention-to-treat (mITT) and per-protocol analyses.
Overall, 853 patients from 3 medical institutions were included. Effectiveness with first-line 14-day triple therapy with a proton-pomp-inhibitor (PPI), clarithromycin 500 mg, amoxicillin 1,000 mg, all BID, was 93% by mITT (714 patients). In patients allergic to penicillin, first-line 14-day triple therapy with PPI-clarithromycin-metronidazole achieved 83% effectiveness by mITT (35 patients). Second-line 14-day triple therapy with a PPI-amoxicillin-levofloxacin achieved 89% mITT eradication rate (51 patients). Second-line therapy with the 10-day three-in-one single capsule containing bismuth-tetracycline-metronidazole achieved optimal effectiveness (100% mITT) in 10 patients (p = 0.02).
Slovenia is a country with <15% H. pylori resistance to clarithromycin. Triple therapy with a PPI plus 2 antibiotics during 14 days reported optimal effectiveness (over 90%). Ten-day quadruple-bismuth second-line therapy had better results than 14-day triple therapy with levofloxacin.
幽门螺杆菌（H. pylori）是世界上最常见的慢性细菌感染，影响了全球超过 50%的人口。H. pylori 是一级致癌物，导致 89%的非贲门胃癌的发生。在本研究中，我们分析了 3 项国家推荐实施后斯洛文尼亚的 H. pylori 根除治疗数据。
自 2013 年注册成立以来，斯洛文尼亚一直是欧洲幽门螺杆菌管理注册中心的一部分。数据于 2017 年 9 月至 2019 年 12 月，通过 Asociación Española de Gastroenterología-Research Electronic Data Capture 电子病例报告表从西班牙胃肠病学会收集。采用改良意向治疗（mITT）和方案分析评估 H. pylori 根除治疗效果。
共纳入来自 3 家医疗机构的 853 名患者。mITT 分析中，一线 14 天三联疗法（质子泵抑制剂[PPI]、克拉霉素 500mg、阿莫西林 1000mg，bid）的有效率为 93%（714 例患者）。对青霉素过敏的患者，一线 14 天三联疗法（PPI-克拉霉素-甲硝唑）的 mITT 有效率为 83%（35 例患者）。二线 14 天三联疗法（PPI-阿莫西林-左氧氟沙星）的 mITT 根除率为 89%（51 例患者）。10 天三合一单胶囊（含铋、四环素、甲硝唑）二线治疗的 mITT 疗效最佳（100%，10 例患者，p=0.02）。
斯洛文尼亚的 H. pylori 对克拉霉素的耐药率<15%。14 天 PPI 加 2 种抗生素三联疗法的疗效最佳（>90%）。10 天四联铋二线治疗的效果优于 14 天左氧氟沙星三联治疗。
