Gisbert J P, Boixeda D, Alvarez Baleriola I, Martín de Argila C, Bermejo F, Aller R
Servicio de Gastroenterología, Hospital Ramón y Cajal, Madrid.
Rev Clin Esp. 1996 Sep;196(9):588-93.
To study the efficiency of the combination lansoprazole and amoxicillin on the eradication of Helicobacter pylori and duodenal ulcer healing.
Twenty-nine duodenal ulcer patients infected with H. pylori were prospectively studied (mean age, 46 +/- 11 years, 90% males). During endoscopy biopsies were obtained from gastric antrum and body for histologic examination (H & E); a urea breath test with 13C was also performed. Therapy with lansoprazole 30 mg/12 h and amoxicillin 500 mg/6 h for two weeks was prescribed. One month after completing therapy another endoscopy was performed (with biopsies obtained from gastric antrum and body) and again a urea breath test performed. Eradication was defined as the absence of H. pylori by both diagnostic methods.
Eradication was achieved in 48% of patients (n = 14). Ulcer healing was obtained in 62% of cases (n = 18). When eradicating therapy was successful the percentage of healing reached 100%, versus 27% in those patients with persisting infection (p < 0.001). In patients with eradication obtained an histological improvement was noted both at gastric antrum and body, whereas when therapy failed no significant changes were observed. In all cases compliance with therapy was completed, and in no patient were secondary effects observed.
The association of lansoprazole and amoxicillin at the administered doses has a low efficiency on H. pylori eradication in duodenal ulcer patients. Further studies are warranted to definitely assess the eradicating efficiency of such combination and also to determine the optimal dose of its components, the minimal duration of therapy and the ideal moment for its administration.
研究兰索拉唑与阿莫西林联合使用对根除幽门螺杆菌及十二指肠溃疡愈合的疗效。
对29例感染幽门螺杆菌的十二指肠溃疡患者进行前瞻性研究(平均年龄46±11岁,90%为男性)。在内镜检查时,从胃窦和胃体取活检组织进行组织学检查(苏木精-伊红染色);同时进行13C尿素呼气试验。给予兰索拉唑30mg/12小时和阿莫西林500mg/6小时治疗两周。治疗结束后1个月再次进行内镜检查(从胃窦和胃体取活检组织),并再次进行尿素呼气试验。根除定义为两种诊断方法均未检测到幽门螺杆菌。
48%的患者(n = 14)实现了根除。62%的病例(n = 18)溃疡愈合。根除治疗成功时愈合率达到100%,而持续感染患者的愈合率为27%(p < 0.001)。根除治疗成功的患者胃窦和胃体的组织学均有改善,而治疗失败的患者未观察到明显变化。所有病例均完成了治疗,且未观察到患者出现副作用。
所给剂量的兰索拉唑和阿莫西林联合使用对十二指肠溃疡患者根除幽门螺杆菌的疗效较低。有必要进一步研究以明确评估这种联合用药的根除疗效,并确定其成分的最佳剂量、最短治疗疗程及理想给药时机。