幽门螺杆菌感染治疗对慢性阻塞性肺疾病患者临床特征的影响

Investigation on effect of Helicobacter pylori treatment on clinical characteristics of chronic obstructive pulmonary disease

目的探讨幽门螺杆菌(Hp)感染治疗对慢性阻塞性肺疾病(COPD)患者临床特征的影响,并对比不同治疗方案Hp根除率的差异。方法选取2010年1月-2013年1月收治的98例COPD合并Hp感染患者临床资料,根据治疗方案的不同,分为A组34例、B组34例、C组30例;A及B组均针对Hp感染采取根除治疗,A组采用克拉霉素四联疗法治疗,B组采用莫西沙星四联法治疗;C组患者未采取根除治疗,比较A、B组Hp根除率,记录并比较3组患者治疗前及随访中呼吸功能量表评分(Borg)、肺功能表现、运动承受力、S-Gorge生活质量评分和记录随访期间急性发作次数。结果 A与B组患者Hp根除率分别为50.00%、88.24%,对比差异有统计学意义(P<0.05);根除患者治疗后12个月肺功能表现、运动承受力、Borg评分均优于未根除患者,对比差异有统计学意义(P<0.05);根除患者治疗12个月后S-Gorge生活质量评分、急性发作次数分别为(33.95±5.88)分、(1.19±0.78)次,均优于未根除患者(43.48±6.12)分、(2.03±0.93)次,对比差异有统计学意义(P<0.05)。结论 COPD患者Hp感染根除后,可提升呼吸功能及运动耐受力并降低急性发作发生率,改善生活质量;莫西沙星四联疗法对COPD患者根除Hp临床效果更好,可酌情选用。

OBJECTIVE To investigate the effect of Helicobacter pylori （Hp） eradication on clinical characteristics of chronic obstructive pulmonary disease , and compare the rate of Hp eradication under different therapies . METHODS Totally 98 patients with chronic obstructive pulmonary disease accompanied with Hp infection from Jan .2010 to Jan .2013 were divided into group A （34 cases） ,group B （34 cases） and group C （30 cases） according to different therapies .Patients of groups A and B received Hp eradication ,among which patients of group A were treated with clarithromycin quadruple therapy , and patients of group B were treated with moxifloxacin quadruple therapy while patients of group C were not eradicated .The rate of Hp eradication was compared between groups A and B .Borg‐dyspnea score ,pulmonary function ,exercise tolerance evaluation ,S‐Gorge quality of life in the three groups were recorded before treatment and 12 months after treatment ,and frequencies of acute exacerbation during the follow up were recorded .RESULTS The rate of Hp eradication in group A and group B were 50 .00% and 88 .24% ,the difference was significant（P〈0 .05） .Pulmonary function , exercise tolerance evaluation ,Borg‐dyspnea score of Hp eradicated patients were better than those of uneradicated patients at 12 months after treatment ,the difference was significant （P〈0 .05） .S‐Gorge quality of life and fre‐quencies of acute exacerbation at 12 months after treatment were （33 .95 ± 5 .88） points ,（1 .19 ± 0 .78） times in Hp eradicated patients ,all better than （43 .48 ± 6 .12） points ,（2 .03 ± 0 .93） times in uneradicated patients ,the difference was significant（P〈 0 .05） .CONCLUSION Hp eradication in COPD patients is helpful for improving respiratory function ,exercise tolerance ,quality of life ,and decreasing the frequency of acute exacerbation .The Moxifloxacin quadruple therapy can achieve better Hp eradication results which can be adopted as appropriate .