三联疗法治疗Hp阳性胃溃疡患者的预后影响因素

Prognostic factors of effect of triple therapy on patients with Helicobacter pylori positive gastric ulcer

目的 探讨影响幽门螺旋杆菌（Hp）阳性胃溃疡患者预后的因素.方法 选取2012年1月至2014年6月128例应用三联疗法（埃索美拉唑＋替硝唑＋阿莫西林）治疗的Hp阳性胃溃疡患者临床资料,应用单因素及Logistic多因素分析影响三联疗法治疗Hp阳性胃溃疡患者预后相关因素.结果 128例Hp阳性胃溃疡患者经三联疗法治疗后,治愈48例（37.50%）,显效32例（25.00%）,有效18例（14.06%）,无效30例（23.44%）.经单因素分析显示,年龄、用药依从性、吸烟习惯、CYP2C19基因多态性、胃溃疡直径、血清胃蛋白酶原I（PG）水平、埃索美拉唑药敏、替硝唑药敏、阿莫西林药敏与三联疗法疗效有关（P〈0.05）.经Logistic多因素分析,用药依从性、吸烟习惯、CYP2C19基因多态性、血清PG水平、阿莫西林药敏是影响三联疗法治疗Hp阳性胃溃疡患者预后的独立危险因素.结论 对影响三联疗法治疗Hp阳性胃溃疡患者预后的相关危险因素进行分析,并采取有效的干预措施,可有效提高三联疗法治疗Hp阳性胃溃疡的临床疗效.

Objective To investigate the prognostic factors of effect of triple therapy on patients with Helicobacter pylori（Hp） positive gastric ulcer.Methods The clinical data of 128 cases of application of triple therapy（esomeprazole＋tinidazole＋amoxicillin） in the treatment of Hp positive gastric ulcer patients were sellected from Jan.2012 to June 2014.The prognostic factors of effect of triple therapy on patients with Hp positive gastric ulcer were analyzed by univariate and multivariate Logistic analysis.Results After triple therapy treatment, 48 cases（37.50%） were cured, 32 cases（25.00%） were markedly effective, effective in 18 cases（14.06%）, ineffective in 30 cases（23.44%）.Univariate analysis showed that age, medication compliance, smoking habits, CYP2C19 polymorphism, gastric ulcer diameter, serum pepsinogen Ι（PGΙ） level, esomeprazole susceptibility, tinidazole susceptibility, amoxicillin susceptibility were correlated with the effect of triple therapy（P〈0.05）.The medication compliance, smoking habits, CYP2C19 polymorphism, serum PG levels, amoxicillin susceptibility were independent risk factors of the prognosis of patients with Hp positive gastric ulcer underwent triple therapy.Conclusions Analyzing the risk factors related to triple therapy Hp positive gastric ulcer prognosis and taking effective interventions can effectively improve the clinical efficacy of triple therapy on Hp positive gastric ulcer.