不同种质子泵抑制剂组成短程三联疗法根除幽门螺杆菌的比较

Comparison of effects of different proton pump inhibitors on helicobacter pylori and peptic ulcer

目的比较不同种类的质子泵抑制剂(PPI)在相同条件下的抗幽门螺杆菌(HP)的效果及对胃、十二指肠溃疡的治疗效果。方法240例幽门螺杆菌(HP)阳性的胃、十二指肠溃疡病人和慢性胃炎病人随机分成4组,每组60例,分别以奥美拉唑(O)、兰索拉唑(L)、潘妥拉唑(P)、雷贝拉唑(R)4种PPI制剂与阿莫西林(A)和克拉霉素(C)组成三联疗法进行抗HP治疗,疗程7d。慢性胃炎病人停药至少4周后复查;胃、十二指肠溃疡病人结束溃疡治疗至少4周后复查。复查内容包括胃镜检查取胃黏膜作快速尿素酶试验(RUT)、组织学检查(改良美式试验),和13C-尿素呼气检查(13C-UBT)。三项均为阴性者为HP根除。胃和十二指肠溃疡病人同时评判溃疡愈合情况。结果4组抗HP治疗结果以卡方检验进行比较,发现R组与P组间差异存在非常显著意义(P<0.01),其他各组间差异无显著意义(P>0.05)。各治疗组溃疡愈合率差异无显著意义。结论含雷贝拉唑的三联方案HP根除率较高;兰索拉唑抑酸起效较快,更适合作为短程方案使用。

Objective To compare the effects of different proton pump inhibitors （ PPI ） in the same condition on helicebacter pylori （HP） and peptic ulcer. Methods Two hundred and forty patients with gastric,duodenal ulcer or chronic gastritis were divided into four groups ： omeprazole （ O ）, lansoprazole （ L ）, pantoprazole （ P } and rabeprazole （ R ） group. The patients in each group （ 60 cases ） were received respectively one of abovementioned PPI, amoxicillin （A） and clarithromycin （C）. The course of treatment were 7 days. Follow-up examination were caviled out in 4 weeks after treatment. In the patients with eradication of HP,rapid ures test ,histological examination of gastric mucesa, and ^13C-urea breathing test were all nagative. Results The radical rate of HP in R group was higher than that in P group （ P 〈 0.01 ）, but there was no significant differences among other groups （ P 〉 0.05 ）. Conclusion The radical rate of HP using triple project containing rabeprazole is higher.