低剂量标准三联疗法根治Hp及对胃粘膜病变的治疗作用

Therapeutic effects of low dose triple therapy in eradication of Helicobacter pylori and gastric mucosal lesions

目的探讨低剂量标准三联疗法根治Ｈｐ感染及对胃粘膜病变的影响．方法Ｈｐ相关性慢性胃炎患者共７３例，其中男４２例，女３１例，年龄１８岁～６２岁，均给予低剂量标准三联疗法治疗，观察其对Ｈｐ根治率．同时观察治疗前后胃粘膜病理变化．结果低剂量标准三联疗法既保持了较高根治率（８４６％，５５／６５），又降低了副作用；对胃粘膜炎性病变具有明显治疗作用，其中活动性炎症、血管瘀血和肠上皮化生消失率依次为８８９％（１６／１８），８１８％（９／１１）和６６７％（３／９）；非活动性炎症亦表现为治疗后退级或减轻，其中Ⅲ级炎症消失率为８１８％（１８／２２）；但对萎缩或增生性病变无显著疗效．结论低剂量标准三联疗法是治疗Ｈｐ相关性慢性胃炎疗效较高、价廉、副作用较少的Ｈｐ根治方法。

AIM To identify the clinical value of low dose triple therapy on Helicobacter pylori (Hp) infection. METHODS Seventy three patients with Hp related chronic gastritis (42 men, 31 women, aged 18-62 years) were treated with low dose triple therapy. Before and 4 weeks after the therapy, gastric mucosal histopathology was tested and analyzed with blind method, while Hp eradication was observed. RESULTS Low dose triple therapy yielded a high Hp eradication rate (84 6%,55/65) with few side effects. Inflammatory lesions in gastric mucosa were significantly improved 4 weeks after the therapy, with disappearance rates of active inflammation, circulatory stasis and intestinal metaplasia of 88 9%(16/18), 81 8%(9/11) and 66 7%(3/9), respectively. Non active inflammatory lesions were also improved, with the disappearance rate of the inflammation of degree Ⅲ of 81 8%(18/22). But it was not proved to have any effect on gastric mucosal atrophy and proliferation. CONCLUSION Hp infection should be treated in the early stage of Hp related gastritis.