含左氧氟沙星10日序贯疗法对Hp初次根除失败的补救治疗

Levofloxacin Based 10 Day Sequential Therapy as Rescue Therapy for Hp Infection with a Previous Failed Course

目的评价含左氧氟沙星的10日序贯疗法补救治疗幽门螺杆菌(Hp)感染的有效性和安全性。方法对44例Hp初次根除失败的消化性溃疡或慢性胃炎患者采用含左氧氟沙星的10日序贯治疗方案:前5d给予口服埃索美拉唑(20mg)+枸橼酸铋钾(220mg)+左旋氧氟沙星(200mg)+阿莫西林(1000mg),bid;后5d给予口服埃索美拉唑(20mg)+枸橼酸铋钾(220mg)+左旋氧氟沙星(200mg)+呋喃唑酮(100mg),bid。4周后通过14C呼气试验判断Hp根除情况。结果3例失访,余41例完成治疗及随访,其中35例补救根除成功,6例补救治疗失败,6例(13.64%)患者发生轻微不良反应,根据意向处理(ITT)分析和完成治疗(PP)分析,根除率分别为79.55%(35/44)和85.37%(35/41)。结论含左氧氟沙星的10日序贯治疗方案为安全有效的幽门螺杆菌感染补救治疗方案。

Objective To evaluate the efficacy and tolerability of levofloxacin based 10 day sequential therapy as rescue therapy after a failed first line triple regimen therapy.Methods Forty-four cases of peptic ulcer or chronic gastritis with a previous failed course of first line therapy were given the following 102 day levofloxacin based sequential therapy：esomeprazole（20 mg）bid.plus bismuth citrate 220 mg bid,levofloxacin 200 mg bid and amoxicillin 1 000 mg bid for the first 5 days.Esomep razol （20 mg）bid plus bismuth citrate 220 mg bid,levofloxacin 200 mg bid and furazolidone 100 mg bid for the last 5 days.The status of Helicobacter pylori post therapy was assessed by 14C breath test.Results Three patients dropped out in follow up,the other 41 enrolled patients completed the treatment. Among of them,35 patients were eradicated successfully,6 patients remained 14C breath test positive.Slight or mild side effects occurred in 6 （13.64%）patients.About 79.55%（35/44）and 85.37%（35/41） of patients were eradicated according to intention to treat and perprotocol analysis,respectively.Conclusion Levofloxacin based 10 day sequential therapy is an effective and safe rescue therapy after a failed first line triple therapy.