克拉霉素等三联短疗程治疗幽门螺杆菌感染的临床研究

Clarithromycin triple therapy for helicobacter pylori infection

为了解小儿上消化道幽门螺杆菌（Ｈｐ）感染用克拉霉素等三联疗法治疗的疗效，用纤维胃镜对具有消化道症状的患儿进行胃粘膜组织学、尿素酶检查。对３０例Ｈｐ感染阳性，胃、十二指肠炎及溃疡患儿给以克拉霉素每次７～１０ｍｇ／ｋｇ，奥美拉唑每次５～２０ｍｇ，替硝唑每次１０～１２．５ｍｇ／ｋｇ，均每日２次口服，疗程１０天。有溃疡患儿继用奥美拉唑或雷尼替丁直至复查。停药１个月后行胃镜复查，取胃粘膜做银染、尿素酶检查Ｈｐ，两项阴性为Ｈｐ根除。结果显示，Ｈｐ根除率为９７％，且全部患儿症状缓解或消除，药物不良反应率为４０％，但无一例影响治疗。说明克拉霉素等三联短疗程治疗方案疗效好。患儿依顺性好，并可避免长期用抗生素而产生的副作用，可望替代传统的三联治疗。

The aim of this clinical study was to evaluate the efficacy and safety of a triple anti bacterial therapy including clarithromycin in treatment of Helicobacter pylori (Hp) infection in children. Thirty patients with Hp associated chronic gastroduodenitis and gastroduodenal ulcer were treated with clarithromycin 7～10mg/kg once a day, omeprazole 5～20mg and tinidazole 10～12.5mg/kg, twice daily for 10 days. The Hp status was determined by rapid urease and histology of Warthin Starry silver stain thirty days after treatment. The Hp eradication rate was 97%. The frequency of side effects was 40%, but none of which led to discontinuation of the medication. These results suggest that the triple therapy with clarithromycin, omeprazole and tinidazole is an effective and well tolerated treatment for eradication of Hp infection in children and may be an alternative regimen to the standard triple therapy.