十天铋剂四联疗法用于老年患者一线抗幽门螺杆菌感染的疗效与安全性——一项多中心真实世界报告

Efficacy and safety of ten-day bismuth quadruple therapy for first-line anti-Helicobacter pylori infection in the elderly- A multicenter real-world report.

作者信息

Huang Kuo-Hsuan, Tai Wei-Chen, Tsay Feng-Woey, Hsu Pin-I, Wu Deng-Chyang, Loke Song-Seng, Yao Chih-Chien, Chuah Seng-Kee, Liang Chih-Ming

机构信息

Kaohsiung Municipal Fong Shan Hospital - Under the management of Chang Gung Medical Foundation, Taiwan; Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Taiwan.

Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Taiwan; Kaohsiung Municipal Ta-Tung Hospital, Taiwan; Chang Gung University College of Medicine, Taiwan; Department of Leisure and Sport Management, Cheng Shiu University, Kaohsiung, Taiwan.

出版信息

J Microbiol Immunol Infect. 2025 Jul 2. doi: 10.1016/j.jmii.2025.06.010.

DOI:10.1016/j.jmii.2025.06.010

PMID:40619293

Abstract

BACKGROUND

Aging may influence the effectiveness of Helicobacter pylori (H. pylori) eradication. The purpose of this study was to evaluate the efficacy and safety of 10-day bismuth quadruple therapy as a first-line treatment for H. pylori infection in elderly individuals.

METHODS

We conducted a retrospective analysis of prospectively collected data from September 2018 to December 2021 in southern Taiwan. All patients received 10-day quadruple therapy consisting of rabeprazole 20 mg twice daily, bismuth subcitrate 120 mg four times daily, metronidazole 500 mg three times daily, and tetracycline 500 mg four times daily. Patients were categorized into two groups: an elderly group (aged ≥65) and a control group (aged <65).

RESULTS

The study included 231 naive patients receiving 10-day quadruple therapy. The eradication rates in the elderly and control groups were 80.3 % (95 % confidence interval [CI]: 68.1 %-89.4 %) and 85.3 % (95 % CI: 79.1 %-90.3 %) (P = 0.364), respectively, in the intention-to-treat analysis. In the per-protocol analysis, eradication rates were 89.1 % (95 % CI: 77.8 %-95.9 %) for the elderly group and 94.8 % (95 % CI: 90.0 %-97.7 %) for the control group (P = 0.149). Adverse event rates were 34.5 % in the elderly group and 27.5 % in the control group (P = 0.322). Compliance was slightly lower in the elderly group than the control group (89.1 % vs. 95.4 %, P = 0.096).

CONCLUSIONS

The efficacy of 10-day bismuth quadruple therapy as a first-line treatment for H. pylori was comparable between elderly and non-elderly cohorts, with similar levels of adverse effects.

摘要

背景

衰老可能会影响幽门螺杆菌（H. pylori）根除治疗的效果。本研究旨在评估10天铋剂四联疗法作为老年个体幽门螺杆菌感染一线治疗方案的疗效和安全性。

方法

我们对2018年9月至2021年12月在台湾南部前瞻性收集的数据进行了回顾性分析。所有患者均接受为期10天的四联疗法，包括雷贝拉唑20毫克，每日两次；枸橼酸铋钾120毫克，每日四次；甲硝唑500毫克，每日三次；四环素500毫克，每日四次。患者分为两组：老年组（年龄≥65岁）和对照组（年龄<65岁）。

结果

该研究纳入了231例接受10天四联疗法的初治患者。在意向性分析中，老年组和对照组的根除率分别为80.3%（95%置信区间[CI]：68.1%-89.4%）和85.3%（95%CI：79.1%-90.3%）（P = 0.364）。在符合方案分析中，老年组的根除率为89.1%（95%CI：77.8%-95.9%），对照组为94.8%（95%CI：90.0%-97.7%）（P = 0.149）。老年组的不良事件发生率为34.5%，对照组为27.5%（P = 0.322）。老年组的依从性略低于对照组（89.1%对95.4%，P = 0.096）。