FACTORS INFLUENCING THE ERADICATION OF HELICOBACTER-PYLORI WITH TRIPLE THERAPY
FACTORS INFLUENCING THE ERADICATION OF HELICOBACTER-PYLORI WITH TRIPLE THERAPY
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DOI：
10.1016/0016-5085(92)90095-g
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发表时间：
1992-02-01
期刊：
影响因子：
29.4
通讯作者：
GENTA, RM
中科院分区：
文献类型：
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作者：
GRAHAM, DY;LEW, GM;GENTA, RM
幽门螺杆菌感染与胃炎、十二指肠溃疡、胃溃疡和流行性胃癌有关。根除H.幽门螺杆菌感染已被证明是困难的。最近，抗菌药物组合已被证明可以根除> 50% 的感染；然而，结果已被证明是可变的，影响治疗效果的因素尚不清楚。在本研究中，三联疗法根除幽门螺杆菌的有效性。评估幽门螺杆菌感染。三联疗法包括每天 2 g 四环素、750 mg 甲硝唑和 5 至 8 片次水杨酸铋，治疗 93 名患者（70 名十二指肠溃疡，17 名胃溃疡，6 名单纯幽门螺杆菌胃炎）。结合使用敏感尿素呼气试验、血清学、培养和组织学来确认感染、根除或复发的存在。根除被定义为无法显示H。结束治疗后≥1个月。总体根除率为87%。评估预测根除效果的因素包括年龄、性别、疾病类型、治疗持续时间、次水杨酸铋用量[每天五或八片 Pepto-Bismol 片剂（宝洁公司，辛辛那提，俄亥俄州）]，以及对处方药物的依从性。逐步回归表明，依从性是预测成功的最重要因素；服用超过 60% 处方药物的患者的成功率为 96%，服用较少药物的患者的成功率为 69%。对于接受超过 60% 处方治疗的患者，根除率相似 (a) 接受治疗 14 天或额外服用四环素和碱式水杨酸铋 14 天的患者； (b)适用于十二指肠溃疡、胃溃疡、单纯性胃溃疡患者。幽门胃炎; (c) 是否服用五片或八片次水杨酸铋片。结论是三联疗法对于根除幽门螺杆菌是有效的。 pylori 和未来的研究需要考虑依从性以进行治疗方案之间的比较。
Helicobacter pyloriinfection has been associated with gastritis, duodenal ulcer, gastric ulcer, and the epidemic form of gastric carcinoma. Eradication ofH. pyloriinfection has proven to be difficult. Recently, combinations of antimicrobial drugs have been shown to eradicate > 50% of infections; however, the results have proven variable, and the factors influencing effectiveness of therapy are unclear. In the present study, the effectiveness of a triple therapy for eradication ofH. pyloriinfection was evaluated. Triple therapy consisted of 2 g tetracycline, 750 mg metronidazole, and five or eight tablets of bismuth subsalicylate daily in 93 patients (70 with duodenal ulcer, 17 with gastric ulcer, and 6 with simpleH. pylorigastritis). Combinations of a sensitive urea breath test, serology, culture, and histology were used to confirm the presence of infection, eradication, or relapse. Eradication was defined as inability to showH. pylori≥1 month after ending therapy. The overall eradication rate was 87%. The factors evaluated for their effect on predicting eradication included age, gender, type of disease, duration of therapy, amount of bismuth subsalicylate [five or eight Pepto-Bismol tablets daily (Procter & Gamble, Cincinnati, OH)], and compliance with the prescribed medications. Stepwise regression showed that compliance was the most important factor predicting success; the success rate was 96% for patients who took > 60% of the prescribed medications and 69% for patients who took less. For those taking > 60% of the prescribed therapy, the eradication rates were similar (a) for patients receiving therapy for 14 days or when tetracycline and bismuth subsalicylate were taken for an additional 14 days; (b) for patients with duodenal ulcer, gastric ulcer, and simpleH. pylorigastritis; and (c) whether five or eight bismuth subsalicylate tablets were taken. It is concluded that triple therapy is effective for eradication ofH. pyloriand that future studies need to take compliance into account for comparisons between regimens.