幽门螺杆菌根除率非药物影响因素Logistic回归分析及对策

Logistic regression analysis and countermeasure of non-drug influencing factors on Helicobacter pylori eradication rate

目的分析幽门螺杆菌(Helicobacter pylori,H.pylori)根除率的非药物影响因素以及相关对策。方法选取H.pylori感染阳性的消化性溃疡或慢性胃炎患者98例,所有患者接受铋剂四联方案(雷贝拉唑+枸橼酸铋钾胶囊+阿莫西林+克拉霉素)根除治疗2周,疗程结束4周后复查 14 C呼气试验观察H.pylori根除效果,分析影响H.pylori根除率的非药物因素,进一步总结防范对策。结果 98例患者中H.pylori根除成功75例,根除率为 76.5%。未饮用刺激性饮品(茶、咖啡)、消化性溃疡和体重指数<25者H.pylori根除率高于饮用刺激性饮品(茶、咖啡)、慢性胃炎、体重指数≥25者,差异均有统计学意义( P < 0.05)。Logistic回归分析结果显示,饮用刺激性饮品、慢性胃炎和体重指数≥25是影响H.pylori根除率的危险因素。结论控制刺激性饮品饮用量、纠治慢性胃炎、超重或者肥胖患者延长疗程或者适量增加药物剂量,可以提高H.pylori根除率。

Objective To analyze the non-drug influencing factors on eradication rate of Helicobacter pylori(H.pylori) and related countermeasures. Methods Ninety-eight patients with H.pylori-positive peptic ulcer or chronic gastritis were selected.All patients were treated with bismuth quadruple regimen(rabeprazole+bismuth potassium citrate capsule+amoxicillin+clarithromycin) for eradication therapy about 2 weeks.After four weeks at the end of the course of treatment,14 C breath test was reexamined to observe the result of H.pylori eradication.The non-drug factors influencing the eradication rate of H.pylori were analyzed,and then the preventive measures were further summarized. Results H.pylori eradication was successful in 75 out of 98 patients,the eradication rate was 76.5%.The eradication rates of H.pylori in those who did not drink stimulating drinks(tea,coffee),peptic ulcer and body mass index < 25 were higher than those who drank stimulating drinks(tea,coffee),chronic gastritis and body mass index(≥25),there were statistical significance( P < 0.05).Logistic regression analysis showed that drinking stimulating drinks,chronic gastritis and body mass index(≥25) were risk factors for H.pylori eradication rate. Conclusion The eradication rate of H.pylori can be improved by controlling the consumption of stimulating drinks,curing chronic gastritis,prolonging the course of treatment about overweight or obese patients,and appropriately increasing the dosage of drugs.