富马酸伏诺拉生替代PPI治愈难治性幽门螺杆菌感染

Vonoprazan fumarate replaces PPI in the cure of refractory Helicobacter pylori infection

目的探讨钾离子竞争性酸阻滞剂(potassium-competitive acid blocker,P-CAB)富马酸伏诺拉生替代质子泵抑制剂(proton pump inhibitor,PPI)治疗持续难治性幽门螺杆菌(Helicobacter pylori,H.pylori)感染的临床疗效。方法12例H.pylori感染慢性胃炎患者,男7例,女5例,年龄41~70岁,均给予PPI+铋剂+阿莫西林+克拉霉素或左氧氟沙星+呋喃唑酮等治疗2~3个疗程,H.pylori仍持续阳性2年以上。均给予富马酸伏诺拉生20 mg,1次/d,枸橼酸铋钾胶囊2粒,3次/d,左氧氟沙星0.5 g,2次/d,阿莫西林1.0 g,2次/d,用药2周。停药后1个月行^(13)C尿素呼气试验。结果12例患者^(13)C尿素呼气试验均呈阴性。结论富马酸伏诺拉生联合铋剂及抗生素有助于根治难治性H.pylori持续感染。

Objective To explore the clinical efficacy of potassium-competitive acid blocker(P-CAB)Vonoprazan fumarate instead of proton pump inhibitor(PPI)in the treatment of persistent refractory Helicobacter pylori(H.pylori)infection.Methods 12 patients with chronic gastritis infected by H.pylori,7 males and 5 females,aged 41-70 years old,were treated with PPI+Bismuth+Amoxicillin+Clarithromycin or Levofloxacin+Furazolidone etc.2-3 courses,H.pylori continued to be positive for more than 2 years.They were given Vonoprazan fumarate 20 mg,once a day,two Bismuth potassium citrate capsules 3 times a day,Levofloxacin 0.5 g,twice a day,and Amoxicillin 1.0 g,twice a day for 2 weeks.A ^(13)C-urea breath test was performed one month after the drug was stopped.Results The ^(13)C-urea breath test of 12 patients was negative.Conclusion Vonoprazan fumarate combined with Bismuth and antibiotics can help cure persistent infection of refractory H.pylori.