Piubello W, Aimo G, Soldinger E, Pistoso S, Raggi G, Superti G, Bonesi R, Vitali E
Divisione di Medicina, Ospedale Civile, Salò, Brescia.
Recenti Prog Med. 1993 Jan;84(1):40-4.
Although the aetiopathogenetic role of Helicobacter Pylori (HP) in duodenal ulcer and in chronic gastritis seems now well defined, we have not yet standardized therapeutic schedules to achieve disappearance of HP. This study was aimed at evaluating the efficacy of two different therapeutic schedules, colloidal bismuth alone [CB(1200 mg/day)], vs. association with amoxicillin [CB+A(3 g/day)] for six weeks, to clear HP from antral specimens in a cohort of dyspeptic patients. 49 consecutive patients (23 females, 26 males, mean age 47 years, range 22-69) with HP in gastric specimens, 30 suffering from chronic antral gastritis (CG) and 19 affected by duodenal ulcer (DU) were treated with CB (37 pts) or with CB+A (12 pts). DU patients were given also H2-blockers. These latter patients were all healed at the endoscopic control performed after therapy. 4 out of 13 DU patients (31%) treated with CB were found HP free. In 4 out of 6 DU patients (66%) treated with CB+A, HP was no more detectable. As for CG patients, 12 out of 24 (50%) were free from HP at control when treated with CB, while only 2 out of 6 (33%) when CB+A was administered. This study suggests that colloidal bismuth is more effective when administered associated with amoxicillin, but this concerns only DU patients. No relation between endoscopic healing of UD and HP presence was found.
尽管幽门螺杆菌（HP）在十二指肠溃疡和慢性胃炎发病机制中的作用目前似乎已明确，但我们尚未制定出能使HP消失的标准化治疗方案。本研究旨在评估两种不同治疗方案的疗效，即单独使用胶体铋[CB（1200毫克/天）]与联合阿莫西林[CB+A（3克/天）]治疗六周，以清除一组消化不良患者胃窦标本中的HP。49例连续患者（23例女性，26例男性，平均年龄47岁，范围22 - 69岁）胃标本中有HP，其中30例患有慢性胃窦炎（CG），19例患有十二指肠溃疡（DU），分别接受CB（37例）或CB+A（12例）治疗。DU患者还给予了H2受体阻滞剂。这些患者在治疗后进行的内镜检查中均已愈合。接受CB治疗的13例DU患者中有4例（31%）HP检测不到。接受CB+A治疗的6例DU患者中有4例（66%）HP检测不到。对于CG患者，接受CB治疗的24例中有12例（50%）在检查时HP检测不到，而接受CB+A治疗的6例中只有2例（33%）检测不到。本研究表明，胶体铋与阿莫西林联合使用时更有效，但仅针对DU患者。未发现十二指肠溃疡的内镜愈合与HP存在之间的关联。
