含艾司奥美拉唑的四联疗法在幽门螺杆菌相关慢性萎缩性胃炎治疗中的疗效及安全性研究

Study on the efficacy and safety of esomeprazole-containing quadruple therapy in the treatment of Helicobacter pylori-related chronic atrophic gastritis

目的研究含艾司奥美拉唑的四联疗法在幽门螺杆菌相关慢性萎缩性胃炎中的疗效及安全性。方法171例慢性萎缩性胃炎合并幽门螺杆菌感染患者,按照不同治疗方案分为A组(98例)与B组(73例)。A组采用艾司奥美拉唑+阿莫西林+克拉霉素+枸橼酸铋钾胶囊治疗;B组采用奥美拉唑+阿莫西林+克拉霉素+枸橼酸铋钾胶囊治疗。比较两组幽门螺杆菌根除率、血清炎症因子水平、胃黏膜组织病理学评分、不良反应发生情况。结果A组患者幽门螺杆菌根除率94.90%高于B组的78.08%,差异有统计学意义(P<0.05)。治疗后,A组血清超敏C反应蛋白(0.22±0.07)mg/L、白细胞介素-6(24.28±1.33)ng/ml、肿瘤细胞因子-α(1.22±0.16)μg/ml均低于B组的(0.75±0.13)mg/L、(30.31±2.42)ng/ml、(1.76±0.41)μg/ml,差异有统计学意义(P<0.05)。A组黏膜慢性炎症评分(0.97±0.08)分、活动度评分(0.93±0.07)分、腺体萎缩评分(0.34±0.03)分、肠上皮化生评分(0.25±0.02)分均低于B组的(1.56±0.12)、(1.34±0.15)、(1.02±0.11)、(1.01±0.09)分,差异有统计学意义(P<0.05);两组异型增生评分比较,差异无统计学意义(P>0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论艾司奥美拉唑联合阿莫西林在幽门螺杆菌相关慢性萎缩性胃炎的治疗应用中疗效确切、安全可靠。

Objective To study the efficacy and safety of esomeprazole-containing quadruple therapy in the treatment of Helicobacter pylori-related chronic atrophic gastritis.Methods A total of 171 patients with Helicobacter pylori-related chronic atrophic gastritis were divided into group A(98 cases)and group B(73 cases)according to different treatment regimens.Group A was treated with esomeprazole,amoxicillin,clarithromycin and bismuth potassium citrate capsules,and group B was treated with omeprazole,amoxicillin,clarithromycin and bismuth potassium citrate capsules.Both groups were compared in terms of Helicobacter pylori eradication rate,serum inflammatory factor,gastric mucosal histopathological score,occurrence of adverse reactions.Results The Helicobacter pylori eradication rate 94.90%of group A was higher than 78.08%of group B,and the difference was statistically significant(P<0.05).After treatment,the serum high-sensitivity C-reactive protein(0.22±0.07)mg/L,interleukin-6(24.28±1.33)ng/ml,and tumor necrosis factor-α(1.22±0.16)μg/ml in group A were all lower than(0.75±0.13)mg/L,(30.31±2.42)ng/ml and(1.76±0.41)μg/ml in group B,and the differences were statistically significant(P<0.05).The chronic mucosal inflammation score(0.97±0.08)points,activity score(0.93±0.07)points,gland atrophy score(0.34±0.03)points,and intestinal metaplasia score(0.25±0.02)points of group A were lower than(1.56±0.12),(1.34±0.15),(1.02±0.11),(1.01±0.09)points of group B,and the difference was statistically significant(P<0.05).There was no statistically significant difference in dysplasia scores between the two groups(P>0.05).There was no statistically significant difference in incidence of adverse reactions between the two groups(P>0.05).Conclusion Esomeprazole in combination with amoxicillin is effective and safe in the treatment of Helicobacter pylori-related chronic atrophic gastritis.