Kim Seung Wan, Lee Ju Yup, Park Myeongsoon, Lee Jin Wook, Lee Yoo Jin, Cho Kwang Bum, Jung Hye Ra
Clin Lab. 2023 Oct 1;69(10). doi: 10.7754/Clin.Lab.2023.230512.
The Helicobacter pylori eradication rate with standard triple therapy (STT) is continuously decreasing due to clarithromycin resistance. This study aimed to investigate the eradication rate of empirical and tailored therapy and explore various factors affecting this eradication rate using clarithromycin resistance test data for the last 4 years at a single institution in Daegu.
From August 2018 to July 2021, a total of 1,395 patients diagnosed with H. pylori infection based on rapid urea testing and histology at Keimyung University Dongsan Hospital were retrospectively examined. Participants were classified into the empirical and tailored therapy groups according to the results of the clarithromycin resistance test using the polymerase chain reaction.
The overall eradication rate of empirical STT was 72.8%, and the eradication rate by year was 71.6% in 2018, 77.4% in 2019, 70.3% in 2020, and 70.6% in 2021; the differences were not statistically significant (p = 0.173). No significant difference was noted in the eradication rate according to gender, age, type of proton pump inhibitors, and use of probiotics. Significant differences were noted in the eradication rate according to the treat-ment period: 69.7% in the 7-day, 67.3% in the 10-day, and 81.4% in the 14-day group (p = 0.001). The eradication rate with STT was 87.4% in the non-resistant group. In the case of clarithromycin resistance, treatment was mainly with bismuth quadruple therapy (BQT), and the eradication rate was 86.1%. The eradication rate was higher with administration of BQT for 10 days or 14 days than for administration of BQT for 7 days, but with no statistical significance (p = 0.364).
Extending the treatment period of STT helped in improving the eradication rate, and tailored therapy through clarithromycin resistance testing showed superior results when compared to empirical therapy.
由于对克拉霉素耐药，标准三联疗法（STT）的幽门螺杆菌根除率持续下降。本研究旨在调查经验性治疗和个体化治疗的根除率，并利用大邱一家机构过去4年的克拉霉素耐药检测数据，探讨影响该根除率的各种因素。
回顾性研究2018年8月至2021年7月在庆熙大学东山医院基于快速尿素检测和组织学诊断为幽门螺杆菌感染的1395例患者。根据聚合酶链反应检测的克拉霉素耐药结果，将参与者分为经验性治疗组和个体化治疗组。
经验性STT的总体根除率为72.8%，各年份的根除率分别为：2018年71.6%，2019年77.4%，2020年70.3%，2021年70.6%；差异无统计学意义（p = 0.173）。根据性别、年龄、质子泵抑制剂类型和益生菌使用情况，根除率无显著差异。根据治疗疗程，根除率有显著差异：7天疗程组为69.7%，10天疗程组为67.3%，14天疗程组为81.4%（p = 0.001）。非耐药组STT的根除率为87.4%。对于克拉霉素耐药的情况，主要采用铋剂四联疗法（BQT）治疗，根除率为86.1%。BQT治疗10天或14天的根除率高于BQT治疗7天，但无统计学意义（p = 0.364）。
延长STT的治疗疗程有助于提高根除率，与经验性治疗相比，通过克拉霉素耐药检测进行的个体化治疗显示出更好的效果。
Zotero 插件