332例幽门螺杆菌感染老年患者多次根除治疗的疗效研究

Multiple eradicative therapy of Helicobacter pylori infection in elderly patients： report of 332 cases

目的总结分析幽门螺杆菌（Hp）感染老年患者多次根除Hp治疗后的根除率，探讨反复多次根除Hp治疗疗效及与相关因素的关系。方法回顾性分析Hp检测阳性的老年病例332例，符合Hp根除治疗的标准，曾多次行抗Hp根除治疗，每次治疗停药1个月后均行13C-尿素呼气试验，有明确随访结果。将收集的病例进行统计学率的计算，多个率的比较采用卡方检验。结果332例老年患者经第一次抗Hp根除治疗，211例患者13C-尿素呼气试验检测证实Hp为阴性；首次治疗后检测仍为阳性的121例患者，有117例行第二次抗Hp根除治疗，89例患者治疗后行13C-尿素呼气试验证实Hp检测为阴性；检测仍为阳性的28例患者中有16例进行第三次根除治疗，13例患者治疗1个月后行13C-尿素呼气试验检测证实为阴性。结论对有根除指征的Hp反复阳性老年患者进行及时有效的根除治疗很有必要。反复多次根除治疗时，个体化调整治疗方案，以四联治疗为主，将治疗时间由1周延长为2周，对于提高Hp感染根除率可能有益。

Objective To summarize and analyze the effect of multiple eradicative therapy for Helicobacter pylori （Hp） infection of elderly patients and its related factors. Methods We retrospectively analysed 332 elderly patients with Hp positive,who received multiple anti-Hp eradicative therapy according to the standard of eradication. We also checked every time with C-13 breath test after stopping drug a month, and had clear follow-up results. The collected cases were calculated with the statistical rate, multiple rate compared with Pearson chi-square test. Results Within 332 elderly patients cured by first anti-Hp eradicative therapy, 211 patients were confirmed that Hp was negative with C13 breath test;121 patients still tested positive after the first treatment ,and 117 patients received the second time of eradicative therapy,89 patients were confirmed that Hp was negative with C13 breath test; Testing is still positive for 28 patients, and 16 patients received the third time of eradicative therapy, 13 patients were confirmed that Hp was negative with C13 breath test after a month. Conclusions It is necessary to eradicate Hp timely and effectively for elderly patients with Hp infection eradication indication. To adjust regimens individually with quadruple regimens, and to extend the treatment time from one week to two weeks, may be beneficial for improving the rate of eradication.