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在西班牙,奥美拉唑和阿莫西林联合用药对根除幽门螺杆菌有效吗?

[Is the omeprazole and amoxicillin combination useful in the treatment eradicating Helicobacter pylori in Spain?].

作者信息

Gisbert J P, Mur M, Sainz S, Ceña G, Martín C, Sainz R, Boixeda D, Monés J

机构信息

Servicio de Gastroenterología, Hospital Ramón y Cajal, Madrid.

出版信息

Rev Esp Enferm Dig. 1996 Feb;88(2):99-106.

PMID:8664080
Abstract

AIM

To evaluate the efficiency of omeprazole (20 mg/12 h) plus amoxycillin (1 gr/12 h) in eradicating Helicobacter pylori in duodenal ulcer patients studied in four hospitals in our country.

METHODS

One-hundred and four patients (mean age: 49 +/- 16 years, 67% males) attended at four general hospitals in Spain, who had a duodenal ulcer demonstrated by endoscopy. These patients were infected with H. pylori demonstrated by urease test and histologic methods, and in 32 by a breath test and 18 by culture. Omeprazole 20 mg b.i.d. plus amoxycillin 1 gr b.i.d. was administered for 2 weeks. Endoscopy was repeated 1 month after completing therapy, and the aforementioned diagnostic methods were performed again.

RESULTS

Eradication was achieved in 29% of cases (n = 30). In multiple logistic regression analysis, duration of ulcer disease was the only variable which correlated with success in H. pylori eradication (chi(2) = 7.2; p = 0.02). Additional variables (age, sex, smoking, pre-treatment with omeprazole, AINEs or H2 antagonist, ulcer size, and antral histologic gastritis) were not correlated with H. pylori eradication. Ulcer healing was demonstrated in 80% of patients (n = 83), and the healing rate was higher when eradication was achieved (97%) than in H. pylori-positive patients (73%) (p < 0.01). Compliance was good in all cases. No adverse effects were observed.

CONCLUSION

[corrected] Disappointing results were obtained with omeprazole (20 mg b.i.d.) plus amoxycillin (1 gr b.i.d.) on H. pylori eradication. This combination cannot be recommended in our country at the doses employed in this study.

摘要

目的

评估奥美拉唑(20毫克/12小时)加阿莫西林(1克/12小时)根除我国四家医院十二指肠溃疡患者幽门螺杆菌的疗效。

方法

104例患者(平均年龄:49±16岁,67%为男性)来自西班牙四家综合医院,经内镜检查确诊为十二指肠溃疡。这些患者经尿素酶试验和组织学方法证实感染幽门螺杆菌,其中32例经呼气试验证实,18例经培养证实。给予奥美拉唑20毫克,每日两次,加阿莫西林1克,每日两次,治疗2周。治疗结束1个月后复查内镜,并再次进行上述诊断方法。

结果

29%的病例(n = 30)实现了根除。在多因素逻辑回归分析中,溃疡病病程是唯一与幽门螺杆菌根除成功相关的变量(χ² = 7.2;p = 0.02)。其他变量(年龄、性别、吸烟、奥美拉唑、非甾体抗炎药或H2拮抗剂预处理、溃疡大小和胃窦组织学胃炎)与幽门螺杆菌根除无关。80%的患者(n = 83)溃疡愈合,根除成功的患者愈合率(97%)高于幽门螺杆菌阳性患者(73%)(p < 0.01)。所有病例依从性良好,未观察到不良反应。

结论

奥美拉唑(20毫克,每日两次)加阿莫西林(1克,每日两次)根除幽门螺杆菌的结果令人失望。在我国,本研究中使用的剂量不推荐这种联合用药。

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