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七天三联疗法足以根除幽门螺杆菌感染,而无需 23S rRNA 点突变。

Seven-day triple therapy is sufficient to eradicate infection caused by Helicobacter pylori without 23S rRNA point mutation.

机构信息

Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.

出版信息

Medicine (Baltimore). 2021 May 28;100(21):e26133. doi: 10.1097/MD.0000000000026133.

Abstract

Tailored therapy based on dual priming oligonucleotide-based polymerase chain reaction (DPO-PCR) can be considered an alternative to overcome the low eradication rate in high clarithromycin-resistance areas. The triple therapy (TT) duration of the tailored approach in most studies was 7 days for patients without point mutation. However, recent western guidelines have recommended a treatment duration of 14 days. The aim of this study was to compare the success rate of 7 and 14 days of TT for eradicating Helicobacter pylori without point mutation, as determined by DPO-PCR.Between Feb 2016 and Feb 2019, medical records of patients who underwent DPO-PCR were reviewed. Patients without point mutation as determined by DPO-PCR were enrolled in this study. The eradication success rate and adverse events were evaluated.A total of 366 patients without A2142G and A2143G point mutation were enrolled. The success rates of 7-day and 14-day TT were 88.4% (168/190) and 85.9% (151/176) by intention to treat analysis (P = .453) and 90.8% (168/185) and 90.4% (151/167) by per-protocol analysis (P = .900), respectively. The adverse event rates showed no significant difference between the 2 groups.In patients without point mutation based on DPO-PCR results, 7-day TT is as effective as 14-day TT. Therefore, 7 days may be considered as a cost-effective treatment duration in Korea.

摘要

基于双重引物聚合酶链反应(DPO-PCR)的个体化治疗可被视为克服高克拉霉素耐药地区低根除率的替代方法。在大多数研究中,对于无点突变的患者,个体化治疗的三联疗法(TT)疗程为 7 天。然而,最近的西方指南建议治疗疗程为 14 天。本研究旨在比较 DPO-PCR 检测无点突变的患者接受 7 天和 14 天 TT 治疗的根除成功率。

2016 年 2 月至 2019 年 2 月,回顾了接受 DPO-PCR 的患者的病历。本研究纳入了 DPO-PCR 检测无点突变的患者。评估了根除成功率和不良反应。

共纳入 366 例无 A2142G 和 A2143G 点突变的患者。意向治疗分析的 7 天和 14 天 TT 的成功率分别为 88.4%(168/190)和 85.9%(151/176)(P=0.453),按方案分析的成功率分别为 90.8%(168/185)和 90.4%(151/167)(P=0.900)。两组的不良反应发生率无显著差异。

在基于 DPO-PCR 结果无点突变的患者中,7 天 TT 与 14 天 TT 同样有效。因此,7 天可能被视为韩国一种具有成本效益的治疗疗程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ba0/8154452/bbc6d3e81d3b/medi-100-e26133-g001.jpg

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