Jaspersen D, Körner T, Schorr W, Brennenstuhl M, Hammar C H
Division of Gastroenterology, Academic Medical Hospital, Fulda, Germany.
J Gastroenterol. 1995 Jun;30(3):319-21. doi: 10.1007/BF02347506.
Thirty-five patients with duodenal ulcer bleeding and Helicobacter pylori-colonization were assigned to receive 2 x 20 mg omeprazole and 3 x 750 mg amoxycillin daily for 2 weeks. Eradication was defined as no evidence of H. pylori infection by urease test and by histology 4 weeks after completion of therapy. Two patients were lost to follow up. All ulcers healed completely (100% ulcer healing rate). Twenty-nine out of the 33 patients were H. pylori-negative (87.9% eradication rate). Three patients complained of typical side effects of amoxycillin (9.1% side effect rate). The patients were prospectively followed for 12 months. After ulcer healing, no maintenance therapy was given. One of the 29 patients in whom H. pylori eradication had been successful suffered a second ulcer hemorrhage with H. pylori reinfection (3.4% relapse rate of ulcer bleeding), and this was managed endoscopically. Recurrent ulcer hemorrhage occurred in 2 out of 4 H. pylori-resistant patients. At the end of the follow-up period, of the patients in whom H. pylori eradication had been initially successful, only the patient with re-bleeding remained reinfected. The 4 H. pylori-resistant patients showed persistent H. pylori colonization. In conclusion, omeprazole plus amoxycillin is a safe and effective treatment for eradicating H. pylori; this treatment reduces the relapse rate of duodenal ulcer bleeding.
35例十二指肠溃疡出血且幽门螺杆菌定植的患者被分配接受每日2次、每次20毫克奥美拉唑和每日3次、每次750毫克阿莫西林的治疗，持续2周。根除的定义为治疗结束4周后通过尿素酶试验和组织学检查均无幽门螺杆菌感染的证据。2例患者失访。所有溃疡均完全愈合（溃疡愈合率100%）。33例患者中有29例幽门螺杆菌呈阴性（根除率87.9%）。3例患者抱怨有阿莫西林的典型副作用（副作用发生率9.1%）。对患者进行了为期12个月的前瞻性随访。溃疡愈合后，未给予维持治疗。29例幽门螺杆菌根除成功的患者中有1例因幽门螺杆菌再次感染发生了第二次溃疡出血（溃疡出血复发率3.4%），此次通过内镜进行了处理。4例对幽门螺杆菌耐药的患者中有2例发生了复发性溃疡出血。在随访期结束时，在最初幽门螺杆菌根除成功的患者中，只有再次出血的患者仍存在感染。4例对幽门螺杆菌耐药的患者显示幽门螺杆菌持续定植。总之，奥美拉唑加阿莫西林是根除幽门螺杆菌的一种安全有效的治疗方法；这种治疗降低了十二指肠溃疡出血的复发率。
