预先使用雷贝拉唑对幽门螺杆菌根除率影响的研究

Influence of Pretreatment with Rabeprazole on Eradication Rate of Helicobacter pylori

背景:预先使用质子泵抑制剂(PPI)对幽门螺杆菌(Hp)根除率的影响尚存争议。目的:评价三联疗法实施前使用PPI对Hp根除率的影响。方法:纳入功能性消化不良伴Hp感染患者120例,随机分为A、B组。A组预先给予雷贝拉唑10 mg bid,疗程14 d,继而给予雷贝拉唑10 mg bid+克拉霉素500 mg bid+甲硝唑400 mg bid(RCM方案),疗程14 d;B组给予RCM方案,疗程14 d。治疗结束后4周行13C-尿素呼气试验评估Hp根除疗效。结果:实际完成方案者113例(94.2%)。A组按意向治疗(ITT)和按方案(PP)根除率分别为81.7%、89.1%,B组分别为86.7%、89.7%,两组间差异无统计学意义(P>0.05)。A、B组患者治疗期间不良反应的发生率差异无统计学意义(P=0.60),未见严重不良反应发生。结论:Hp根除治疗前预先使用雷贝拉唑对根除率无影响。

Background： The effect of pretreatment with proton pump inhibitor（PPI） on the eradication rate of Helicobacter pylori（Hp） is still controversial.Aims： To evaluate the influence of pretreatment with PPI on the efficacy of an ensuing triple therapy for Hp eradication.Methods： A total of 120 Hp-infected functional dyspepsia patients were enrolled and randomly assigned into A and B groups.Patients in group A were pretreated with rabeprazole 10 mg bid for 14 days,then rabeprazole 10 mg bid ＋ clarithromycin 500 mg bid ＋ metronidazole 400 mg bid（RCM regimen） were administered for the following 14 days.Patients in group B were given only RCM regimen for 14 days.Four weeks after treatment,13 C-urea breath test were performed to assess Hp eradication.Results： A total of 113（94.2%） patients completed the study.Hp eradication rates by intention-to-treat（ITT） and per-protocol（PP） analysis in group A were 81.7% and 89.1%,and in group B were 86.7% and 89.7%,respectively,there were no significant differences between the two groups（P〈0.05）.Incidence of adverse effect was not significantly different between the two groups（P = 0.60）,and no serious adverse effects were seen.Conclusions： Pretreatment with rabeprazole has no influence on the eradication rate of Hp.