山东大学学报(医学版) ›› 2014, Vol. 52 ›› Issue (7): 45-49.doi: 10.6040/j.issn.1671-7554.0.2013.750
李月月, 左秀丽, 季锐, 陈飞雪, 赵宏宇, 王晗, 郭婧, 张菁媛, 付姗姗, 刘建伟, 李延青
LI Yueyue, ZUO Xiuli, JI Rui, CHEN Feixue, ZHAO Hongyu, WANG Han, GUO Jing, ZHANG Jingyuan, FU Shanshan, LIU Jianwei, LI Yanqing
摘要: 目的 通过比较10天伴同、序贯及含铋剂四联疗法三种方案对Hp的根除率,以确定最佳的四联治疗方案,进而指导临床实践。方法 经快速尿素酶检查证实Hp的患者随机接受伴同方案(奥美拉唑20 mg、阿莫西林1 000 mg、克拉霉素500 mg、替硝唑500 mg)、序贯方案(前5天为奥美拉唑20 mg、阿莫西林1 000 mg,后5天为奥美拉唑20 mg、克拉霉素500 mg、替硝唑500 mg)或含铋剂方案(奥美拉唑20 mg、阿莫西林1 000 mg、克拉霉素500 mg、胶体果胶铋200 mg)治疗,每日2次用药,疗程均为10 d。患者停药后6周进行13C呼气试验检查,结果阴性者判为根除成功。结果 意向性分析时,伴同方案、序贯方案和含铋剂方案对Hp的根除率分别为85.6%、70.7%、85.3%,伴同方案和含铋剂方案均显著优于序贯方案(P<0.05)。符合方案集分析显示,上述3组对Hp的根除率为87.8%、82.8%和88.9%,各方案之间的根除率均无统计学差异(P>0.05)。结论 在临床工作中,10 d含铋剂四联方案可作为经验性治疗Hp感染的首选方案。
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