根除幽门螺杆菌治疗霜斑样病变的初步临床研究

A PRELIMINARY CLINICAL STUDY ON ERADICATING HELICOBACTER PYLORI TO CURE SHIMOFURI LESION

目的 :了解根除幽门螺杆菌 ( HP)对霜斑样病变转归的影响。方法 :检测胃镜诊断的霜斑样病变患者胃窦 HP;把愿意接受胃镜复查者随机给以抑酸 (雷尼替丁 1 5 0 mg,每日 2次 ) 4周治疗与抗 HP(雷尼替丁枸橼酸铋 4 0 0 mg,克拉霉素 5 0 0 mg,甲硝唑 4 0 0 mg,每日 2次 ) 1周疗程后以雷尼替丁 ( 1 5 0 mg,每日 2次 ) 3周治疗 ,结束时重复胃镜观察。结果 :4 2例霜斑样病变中 HP感染率为 92 .9% ( 39/4 2 ) ;其中 2 6例 HP感染者治疗 4周重复胃镜检查 ;雷尼替丁组 1 4例 HP仍然阳性 ,抗 HP组 1 2例 HP转为阴性 ( P<0 .0 5 ) ;前者 5例存在霜斑样病变 (其中 1例形成溃疡 ) ,后者无霜斑样病变及溃疡 ( P=0 .0 4 2 5 )。结论

Objective:To explore the relationship between Helicobacter pylori(HP) and shimofuri lesion.Methods:HP was detected in gastric antrum biopsy specimens of subjects with shimofuri lesion.The subjects were randomized to receive either ranitidine 150 mg two times daily for 4 weeks or 1 week course of anti HP therapy (ranitidine bismuth citrate 400 mg,metronidazole 400 mg and clarithromycin 500 mg,bid),and then plus ranitidine (150 mg,bid) for 3 weeks,and thereafter for second endoscopy.Results:The positive rate of HP in gastric antrum of patients with shimofuri lesion was 92 2%(39/42),in which 26 HP infected subjects were divided into two groups randomly,ranitidine alone (14) and anti HP therapy plus ranitidine (12) and repeated endoscopy after 4 weeks.The rate of HP was 100% in the ranitidine group vs 0% in the anti HP group ( P <0 05) and the endoscopic findings were 5 shimofuri lesions (l complicated with duodenal ulcer) in the ranitidine group vs 0 in the anti HP group ( P =0 0425).Conclusion:Eradicating HP could heal shimofuri lesion.