小剂量克拉霉素三联疗法短疗程治疗儿童消化性溃疡幽门螺杆菌感染的临床研究

Clininc study of short-term triple therapy consisted of small doses clarithromycin in children's petic ulcer with Helicobacter pylori infection

目的研究小剂量克拉霉素三联短程疗法对儿童消化性溃疡幽门螺杆菌(Hp)感染的临床疗效、根除率及不良反应。方法经胃镜检查确诊为消化性溃疡及幽门螺杆菌脲酶快速诊断试验(HPUT)为Hp感染的患儿75例,男57例、女18例。分3组进行对比性研究。A组为大剂量短疗程组、B组为小剂量短疗程组、C组为小剂量长疗程组。小剂量克拉霉素为15 m g/(kg.d),大剂量为30 m g/(kg.d),分2次口服。短疗程为1周,长疗程为2周。结果临床疗效A组有效率为96.6%,B组有效率为90.9%,C组有效率为91.6%,3组间差异无显著性(χ2=0.75,P>0.05)。Hp根除率A组为93.1%、B组为90.9%、C组为95.8%,3组间差异无显著性(χ2=0.75,P>0.05)。不良反应发生率A组为27.6%、B组为4.6%、C组为29.2%。B组与A组之间(χ2=4.57,P<0.05)、B组与C组之间(χ2=4.84,P<0.05)差异均有显著性。结论小剂量克拉霉素、奥美拉唑和阿莫西林三联1周疗法是根除儿童消化性溃疡Hp感染的理想方案,其根除率高、副作用少、耐受性好、疗程短、顺应性好。

Objective To evaluate the theraputic effect,eradication rate and side reflection of a short-term triple therapy consisted of small doses clarithromycin in children＇s petic ulcer with Hplicobacter pylori （H. pylori） infection. Methods A total of 75 children＇s petic ulcer with H. pylori infection were divided 3 Groups and treated by PPI triple therapy consisted of clarithromycin,male 57,female 18. group A was large doses and short treatment course group,clarithromycin 30 mg/（kg · d）,po,twice daily. Group B was small doses and short treatment course group,clarithromycin 15 mg/（kg · d）. Above group＇s treatmrnt course was one week. Group C was small doses and long treatment course group,treatment course was two weeks. Results The total efficiency was 96.6% ,90. 9 %, 91.6 % respectively. There was not significant difference among the three groups （X^2 = 0. 75,P〉0.05）. The H. pylori eradication rate was 93.1%, 90.9 %, 95.8 % respectively. There was not significant difference among the three groups （X^2=0.75 ,P〉0.05）. The side effects rate was 27. 6% ,4.6% ,29.2% respectively. There was significant defference between Group B and Group A （X^2=4.57,P〈0.05） and Group B and Group C（X^2=4.84,P〈 0. 05）. Conclusion Small doses clarithromycin,omeperazole and amoxillin triple therapy for one week was the best to eradicate H. pylori infection with high eradication rate,few side effects, short period of treatment, good compliance.