缺铁性贫血伴幽门螺杆菌感染68例的治疗

Treatment of iron-deficiency anemia in patients with concomitant Helicobacter pylori infection: experience of 68 cases

目的缺铁性贫血目前在我国仍是最常见的贫血类疾病,该研究旨在了解缺铁性贫血伴幽门螺杆菌感染的患儿抗幽门螺杆菌加铁剂治疗的疗效。方法143例缺铁性贫血病例均做13C-呼气试验,其中阳性68例,将68例患者随机分为A,B二组。A组(35例):口服硫酸亚铁加2周治疗幽门螺杆菌的三联疗法;B组(33例):口服硫酸亚铁。结果接受治疗的68例患者中,A,B二组在疗程结束后第8周复查血红蛋白、血清铁及血清铁蛋白均较治疗前有明显上升,且A组患者治疗后血红蛋白、血清铁及血清铁蛋白上升明显高于B组,差异有显著性,均P<0.01。结论幽门螺杆菌感染与缺铁性贫血关系密切,与单独铁剂治疗相比较,加用抗幽门螺杆菌的治疗可加快提高血红蛋白的水平,二者配伍才是治疗缺铁性贫血伴幽门螺杆菌感染患者的最佳方案。

Objective This study aimed to investigate the therapeutic effect of iron supplementation combined with anti-Helicobacter pylofi （ H. Pylofi ） therapy on patients with iron-deficiency anemia with concomitant H. Pylori infection. Methods Sixty-eight out of 143 children with iron-deficiency anemia were confirmed to have concomitant H. Pylori infection by the ^13C-urea breath test. The 68 patients were randomly assigned into two groups： Study group （n = 35 ） and Control group （ n = 33 ）. The Control group received oral ferrous sulfate, with a dosage of 2 mg/kg for three times daily. Iron supplementation together with anti-H. Pylori therapy （ losec 0.8 mg/kg, amoxicillin 50 mg/kg and clazithromycin 15 mg/kg daily for two weeks） was administered in the Study group. The therapeutic effect was compared between the two groups. Results At the 8th week after treatment, the levels of hemoglobin, serum iron and serum ferritin in the two groups significantly increased. The Study group showed significantly higher levels of hemoglobin, serum iron and serum ferritin than the Control group. Conclusions H. Pylofi infection may be associated with iron-deficiency anemia. Iron supplementation together with anti-H. Pylori therapy is more effective than iron supplementation therapy alone on children with iron-deficiency anemia with concomitant H. Pylofi infection.