幽门螺杆菌根除失败后两种补救方案疗效观察

The Study of Two Kinds of Rescue Therapy after a Failed First-Line Triple Regimen Therapy

目的观察含左旋氧氟沙星的雷贝拉唑与枸橼酸铋雷尼替丁(RBC,R)三联疗法补救幽门螺杆菌根除失败后的疗效及用药的安全性。方法入选86例患者均为初次治疗失败且停药4周以上,经胃镜和病理检查诊断为消化性溃疡和慢性萎缩性胃炎,快速尿素酶法检测证实为幽门螺杆菌感染,随机分为雷贝拉唑组(46例)和RBC组(40例)。雷贝拉唑组予以雷贝拉唑10 mg,阿莫西林1000 mg,左旋氧氟沙星200 mg,口服,2次/d,连用10 d;RBC组予以RBC350 mg,阿莫西林1000 mg,左旋氧氟沙星200 mg,口服,2次/d,连用10 d。补救结束4周后复查14C-尿素呼气实验,呼气试验阴性者为幽门螺杆菌补救根除成功,阳性为补救治疗失败。结果雷贝拉唑组补救根除率为76.2%,RBC组为73.0%,两组比较差异无统计学意义(P>0.05)。两组均无严重不良反应。结论两种含左氧氟沙星补救方案对Hp根除率均较满意,用药不良反应率相当。

Ohjective To observe the efficacy and tolerbility of levofloxaein based triple regimen therapy after a failed first-line triple regimen therapy. Methods Eighty-six peptie uleer or ehronic atrophic gastritis patients with a previous failed course of first-line therapy were raudomly divided into the group rabeprazole（46 cases） and the group ranitidine bismuth citrate（ RBC,40 cases）. The group rabeprazole were treated with rabepeazole 10 rag, levofloxacin 200 mg and amoxillin 1 000 nag po bid for 10 days ,the group RBC were treated with RBC 350 mg,levofloxacin 200 mg and amoxillin 1 000 mg po bid for 10 .days. Weeks later, status of Helicobacter pylon post therapy was assessed by 14C-urea breath test. Results Reseue therapy Helieobaeter pylon eradication rate was 76.2% in group raberazole and 73.0% in group RBC, there was no important difference between the two groups, without severe adverse reaetion. Conclusion Levofloxaein based two therapy were effective and safe reseue therapY after a failed first-line triple therapy.