奥美拉唑、左氧氟沙星、阿莫西林联用根除幽门螺杆菌的疗效观察

Efficacy of omeprazole,levofloxacin,amoxicillin for treating Helicobacter pylori infection

目的探讨奥美拉唑、左氧氟沙星、阿莫西林联用10d的治疗方案根除幽门螺杆菌(Helicobacter pylori,Hp)的疗效及安全性。方法选择120例符合条件的Hp阳性的慢性胃炎和消化性溃疡的患者,随机分成两组:治疗组60例,每次采用奥美拉唑20mg、左氧氟沙星200mg、阿莫西林1000mg;对照组60例,每次采用奥美拉唑20mg、阿莫西林1000mg、甲硝唑400mg。两组均为每日两次,口服10d,治疗结束4周后,作14C-尿素呼气试验,观察Hp根除情况、症状及不良反应等。结果治疗组失访2例,对照组因药物不良反应(ADR)退出1例。根据意向处理分析(ITT)和实验方案分析(PP),治疗组的Hp根除率分别为85.00%和87.93%,对照组的Hp根除率分别为71.67%和72.88%。Hp根除率治疗组较对照组明显高,差异有统计学意义(P<0.05)。结论奥美拉唑、左氧氟沙星、阿莫西林10d疗法根除率高,是根除Hp的理想方案,可作为一线治疗选择。

Objective To investigate the efficacy and safety of 10-day administration of omeprazole,levofloxacin,amoxicillin for eradi- cating Helicobacter pylori（Hp）. Methods One hundred and twenty patients with Hp infection suffering from chronic gastritis and peptic ulcer were randomized into treatment group and control group. The patients in treatment group were given omeprazole（ 20 mg） ,levofloxacin（200 mg）, amoxicillin （1 000 mg）, twice a day for 10 d, while in control group received omeprazole （20 mg）, amoxicillin （1 000 mg） ,metronidazole（400 mg） ,twice a day for 10 d. After treatment for 4 weeks,the 14C-urea breath test was performed to evaluate the condition of Hp eradication,the symptoms and side-effects. Results Two patients were lost to follow up in treatment group,while one patient in control group stopped receiving treatment because of severe adverse drug reaction（ADR）. On the intention to treat analysis（ITT） and the perprotocol analysis（ PP）, the eradication rates of lip in treatment group were significantly higher than in control group （85.00% vs 71.67% ,87.93% vs 72.88% ,P〈0.05）. Conclusion The 10 d combined treatment of omeprazole,levofloxacin and amoxicillin,is a better choice for Hp eradication as the first-line treatment, with the higher eradication rates of Hp.