Suzuki M, Kitahora T, Nagahashi S, Suzuki H, Mori M, Hibi T, Ishii H
Division of Gastroenterology, National Tokyo Medical Center and National Ookura Hospital, Japan.
J Clin Gastroenterol. 1998;27 Suppl 1:S183-6. doi: 10.1097/00004836-199800001-00030.
Eradication therapy for Helicobacter pylori (H. pylori) has been established. However, the physiological factors influencing the success of treatment remain unclear. The aim of this study was to analyze these factors and to evaluate the efficacy of sofalcone on H. pylori eradication therapy. Forty-four H. pylori-infected and peptic ulcer patients were enrolled in this study. Twenty-seven patients were treated with lansoprazole (LPZ, 30 mg o.d. for 1-8 weeks) and amoxicillin (AMPC, 500 mg q.i.d, 1-2 weeks), followed by 8 weeks of treatment with famotidine (FAM, 20 mg o.d.). Moreover, sofalcone (SOF, 100 mg t.i.d) was administered to 17 patients throughout the therapeutic period. Endoscopic and serologic evaluations and the urea breath test (UBT) were performed before therapy. At the endoscopic examination, mucosal samples were biopsied and then tissue myeloperoxidase (MPO) content, an index of neutrophil infiltration was measured. Cure of H. pylori infection was determined 8 weeks after the cessation of LPZ. This eradication regimen afforded an overall cure rate of 63.0% (17/27) without SOF and 76.5% (13/17) with SOF. In the control group, treatment success was inversely associated with pre-UBT value (gastric urease activity), whereas this association was not observed in the SOF group. Furthermore, in the patients exhibiting a high preUBT value (>40%), a twofold higher eradication rate was obtained by the administration of SOF. In patients who were successfully eradicated, mucosal MPO level was slightly higher than those of unsuccessful cases, whereas there was no significant association with serum pepsinogen (PG I, PG II) concentration and its ratio (PG I/PG II). These results suggest that a low UBT value is a factor predicting treatment success. SOF administration may improve the eradication rate, especially in the high-UBT subgroup.
幽门螺杆菌（H. pylori）根除疗法已经确立。然而，影响治疗成功的生理因素仍不清楚。本研究的目的是分析这些因素，并评估索法酮对幽门螺杆菌根除治疗的疗效。44例幽门螺杆菌感染的消化性溃疡患者纳入本研究。27例患者接受兰索拉唑（LPZ，30mg每日一次，共1 - 8周）和阿莫西林（AMPC，500mg每日四次，共1 - 2周）治疗，随后接受法莫替丁（FAM，20mg每日一次）治疗8周。此外，17例患者在整个治疗期间服用索法酮（SOF，100mg每日三次）。治疗前进行内镜和血清学评估以及尿素呼气试验（UBT）。在内镜检查时，取黏膜样本进行活检，然后测量组织髓过氧化物酶（MPO）含量，这是中性粒细胞浸润的一个指标。LPZ停药8周后确定幽门螺杆菌感染是否治愈。这种根除方案在未使用SOF时总体治愈率为63.0%（17/27），使用SOF时为76.5%（13/17）。在对照组中，治疗成功与否与UBT前值（胃脲酶活性）呈负相关，而在SOF组中未观察到这种相关性。此外，在UBT前值较高（>40%）的患者中，服用SOF可使根除率提高两倍。在成功根除的患者中，黏膜MPO水平略高于未成功的患者，而与血清胃蛋白酶原（PG I、PG II）浓度及其比值（PG I/PG II）无显著相关性。这些结果表明，低UBT值是预测治疗成功的一个因素。服用SOF可能提高根除率，尤其是在高UBT亚组中。
