左氧氟沙星和克拉霉素在三联疗法中根除幽门螺杆菌的疗效分析

To compare the efficacy of levofloxacin with clarithromycin for Helicobacter pylori eradication in triple therapy

目的比较左氧氟沙星与克拉霉素在三联疗法中根除幽门螺杆菌(Hp)的疗效。方法选择120例体检Hp阳性且要求根除Hp人群。随机分为2组,治疗组采用雷贝拉唑(10mg,2次/d),左氧氟沙星(200mg,2次/d),甲硝唑(400mg,2次/d),治疗7d。对照组采用雷贝拉唑(10mg,2次/d),克拉霉素(500mg,2次/d),甲硝唑(400mg,2次/d),治疗7d。停药4周后复查Hp,分析Hp的根除率。结果治疗组意向处理分析(ITT)根除率为86.67%(52/60),完成治疗分析(PP)根除率为91.23%(52/57)。对照组意向处理分析(ITT)根除率为71.67%(43/60),完成治疗分析(PP)根除率为74.14%(43/58)。治疗组和对照组ITT根除率无明显差异,治疗组PP根除率高于对照组(P<0.05),治疗组与对照组每例根除Hp费用分别为117元、210元,治疗组根除Hp期望成本(每疗程费用/Hp根除率)比对照组低155元。结论以左氧氟沙星为主的三联疗法根除Hp疗效好,且经济、安全,以左氧氟沙星为主的三联疗法是根除Hp的理想治疗方案。

Objective To compare the efficacy of levofloxacin with clarithromycin for Helicobacter pylori(Hp)eradication in triple therapy.Methods A total of 120 Hp-positive normal population were randomized tot reatment group and control group.The treatment group were administered rabeprazole(10mg,twice a day),levofloxacin(200mg,twice a day)and metronidazole(400mg,twice a day)for 7 days,while the control group received rabeprazole(10mg,twice a day),clarithromycin(500mg,twice a day)and metronidazole(100mg,twicea day)for 7 days.Four weeks later,the Hp eradication was observed.Results The Hp eradication rate of ITT(intention to treat)between the treatment group and the control group were 86.67% and 71.67%,respectively.The difference was not significant(P>0.05).The Hp eradication rate of PP(per protocol)between the treatmentg roup and the control group were 91.23%and 74.14%,respectively.The difference was significan(tP<0.05).The cost of anti-Hp therapy of patient was 117 yuan(RMB)and 210 yuan(RMB)in the treatment group andc ontrol group,respectively.Conclusion The levofloxacin is new and ideal drug eradicating Hp.