克拉霉素、胶体次枸橼酸铋和甲硝唑短程联用治疗小儿幽门螺杆菌感染的临床疗效

Efficacy of combination of clarithromycin, colloidal bismuth subcitrate and metronidazole in short-term treatment of helicobacter pylori infection with recurrent abdominal in children

目的 :探讨克拉霉素 (CLA) +胶体次枸橼酸铋 (CBS) +甲硝唑 (Met)短程联用治疗小儿幽门螺杆菌 (HP)感染的疗效。方法 :2 8例经14 C尿素呼吸试验 (14 C UBT)及血清HP IgG测定 2项阳性的反复腹痛患儿 ,随机分为两组。治疗组每日给予CLA。15mg·kg- 1+CBS 8mg·kg- 1+Met 18mg·kg- 1,分两次口服 ,疗程 7d。对照组 (标准三联疗法 )以CBS +Met+AMO(阿莫西林 )治疗 ,CBS和Met的剂量及用法同上 ,AMO剂量为每日 4 0mg·kg- 1,分两次口服 ,疗程 14d。停药后 4wk门诊复诊并复查14 C UBT ,14C UBT阴性为HP根除。结论 :HP根除率 ,治疗组与对照组分别为 92 .3% ,86 .7% ,差异无显著性 (P >0 .0 5 ) ,疼痛缓解率分别为 10 0 % ,93.3% ,差异无显著性 (P >0 .0 5 ) ,药物不良反应分别为 7.7% ,13.3% ,均不影响治疗 ,停药后症状消失。结论 :CLA +CBS +Met三联 7d短程疗法根除反复腹痛儿童HP感染临床疗效确切 ,HP根除率高 ,副作用少 。

AIM: To evaluate the efficacy and safety of a combination therapy of clarithromycin (CLA), colloidal bismuth subcitrate (CBS), and metronidazole (Met) in treatment of helicobacter pylori (HP) infection with recurrent abdominal in children. METHODS: By using the 14 C urea breath test ( 14 C UBT) and serum HP IgG antibody test, 28 patients of HP infection with recurrent abdominal pain were divided into treatment group and control group. The treatment group was given CLA 15 mg·kg -1 bid; CBS 8 mg·kg -1 bid; Met 18 mg·kg -1 bid for 1 wk. The control group was administered CLA 15 mg·kg -1 bid; CBS 8 mg·kg -1 bid; amoxicillin 40 mg·kg -1 bid for 2 wk. All patients were followed up 4 wk after the treatment was completed and 14 C UBT was repeated. RESULTS: HP eradication rates were 92.3 % in treatment group and 86.7 % in control group (P> 0.05 ). The pain relief rates were not statistically significant (P> 0.05 ) between two groups. The side effects were 7.7 % and 13.3 % in treatment group and control group, respectively. CONCLUSION: The combination of CLA+CBS+Met for 1 wk is an effective and safe treatment for eradication of HP infection with recurrent abdominal in children.