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中国人民解放军总医院
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中国人民解放军总医院老年心血管病研究所
中国科技出版传媒股份有限公司
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中华老年多器官疾病杂志编辑委员会
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创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
季红莉,路琴,陈明,黄慧,张汾燕,谢瑞华,唐甜甜,付万发.改良序贯疗法根除老年幽门螺杆菌感染的疗效分析[J].中华老年多器官疾病杂志,2019,18(5):346~349
改良序贯疗法根除老年幽门螺杆菌感染的疗效分析
Efficacy of modified sequential therapy for curing Helicobacter pylori infection in the elderly
投稿时间:2018-12-12  
DOI:10.11915/j.issn.1671-5403.2019.05.071
中文关键词:  老年人;螺杆菌,幽门;改良序贯疗法;四联疗法;根除率
英文关键词:aged; Helicobacter pylori; modified sequential therapy; quadruple therapy; eradication rate Corresponding author:FU Wan-Fa, E-mail:wanfafu@yahoo.com〖FL
基金项目:
作者单位E-mail
季红莉 北京老年医院消化内科,北京 100095  
路琴 北京老年医院消化内科,北京 100095  
陈明 北京老年医院消化内科,北京 100095  
黄慧 北京老年医院消化内科,北京 100095  
张汾燕 北京老年医院消化内科,北京 100095  
谢瑞华 北京老年医院消化内科,北京 100095  
唐甜甜 北京老年医院消化内科,北京 100095  
付万发 北京老年医院消化内科,北京 100095 wanfafu@yahoo.com 
摘要点击次数: 164
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中文摘要:
      目的 评价含甲磺酸左氧氟沙星的改良序贯疗法对老年幽门螺杆菌(H.pylori)感染患者的根除疗效和安全性。方法 收集2017年1月至2018年6月在北京老年医院门诊就诊的老年H.pylori感染良性患者120例,按随机数表法将患者分为改良序贯疗法组(研究组)和铋剂四联疗法组(对照组),各组60例。研究组:先予以埃索美拉唑20mg+阿莫西林1000mg,2次/d,共5d,再予以埃索美拉唑20mg+克拉霉素500mg+甲磺酸左氧氟沙星200mg,2次/d,共5d。对照组:埃索美拉唑20mg+阿莫西林1000mg+克拉霉素500mg+枸橼酸铋钾220mg,2次/d,共14d。对H.pylori根除率进行意向性治疗分析(ITT)及符合方案分析(PP),并比较2组患者不良反应发生率。应用成本-效果分析法对2组方案进行经济效益评价。采用SPSS 17.0统计软件分析。组间比较采用t检验或χ2检验。结果 研究组50例根除成功,6例失访;对照组46例根除成功,5例失访,4例未完成治疗。ITT分析:研究组和对照组根除率分别为83.3%(50/60)和76.7%(46/60),差异无统计学意义(χ2=1.944,P=0.378);PP分析:2组根除率分别为92.6%(50/54)和90.2%(46/51),差异无统计学意义(χ2=0.192,P=0.463)。研究组患者发生不良反应7例(11.7%),无严重不良反应事件;对照组患者发生不良反应12例(20.0%),4例(6.7%)发生严重不良反应事件而终止治疗。2组患者不良反应(χ2=1.563,P=0.159)及严重不良反应(χ2=4.138,P=0.059)发生率比较差异无统计学意义。治疗组与对照组一个疗程费用依次为345.71元和533.71元。按PP分析,治疗组和对照组的成本-效果比(C/E)分别为373.3(345.71/92.6%)和591.7(533.71/90.2%),差异有统计学意义(P<0.05);按 ITT分析,治疗组和对照组C/E分别为415.0(345.71/83.3%)和695.8(533.71/76.7%),差异亦有统计学意义(P<0.05)。结论 含甲磺酸左氧氟沙星的改良序贯疗法对老年患者H.pylori有较好的根除效果,可作为根除H.pylori的一种治疗方案。
英文摘要:
      Objective To evaluate the efficacy and safety of the modified sequential therapy with levofloxacin mesylate for curing Helicobacter pylori (H.pylori) infection in elderly patients. Methods A total of 120 elderly patients with benign H. pylori infection were included in the study, who were treated in Beijing Geriatric Hospital from January 2017 to June 2018. The patients were rando-mized into study group (sequential therapy) and control group (bismuth tetralogy). The study group received esomeprazole 20mg+amoxicillin 1000mg, twice a day for 5d and then esomeprazole 20mg+clarithromycin 500mg+levofloxacin mesylate 200mg, twice a day for 5d; the control group received esomeprazole 20mg+amoxicillin 1000mg+clarithromycin 500mg+bismuth potassium citrate 220mg, twice a day for 14d. Intention-to-treat (ITT) and per-protocol (PP) analysis were performed for the H.pylori eradication rate, and incidence of adverse reactions was compared between 2 groups. The cost-effectiveness analysis was performed to evaluate the economic benefits of two groups. SPSS statistics 17.0 was used for analysis, and t test or χ2 test was used for comparison between 2 groups. Results In the study group, H.pylori was eradicated in 50 patients, with 6 cases being lost to follow-up; in the control group, H.pylori was eradicated in 46 patients with 5 being lost to follow-up and 4 failing to complete the treatment. ITT analysis showedan eradication rate of 83.3%(50/60) for the study group and 76.7%(46/60) for the control group, with no significant difference between 2 groups (χ2=1.944, P=0.378). PP analysis showed an eradication rate of 92.6%(50/54) for the study group and 90.2% (46/51) for the control group, with no significant difference between 2 groups (χ2=0.192, P=0.463). There were 7 adverse reactions (11.7%) but no serious adverse reactions in the study group, and 12(20.0%) adverse reactions and 4(6.7%) serious adverse reactions in the control group, with no significant difference in the incidence of adverse reactions (χ2=1.563, P=0.159) and severe adverse reactions (χ2=4.138, P=0.059) between 2 groups. One course of treatment costed 345.71RMB¥ in study group against 533.71RMB¥ in the control group. According to PP analysis, the cost-effectiveness ratio (C/E) of study group and control group were 373.3(345.71/92.6%) and 591.7(533.71/90.2%) with significant difference (P<0.05). ITT analysis showed a C/E of 415.0(345.71/83.3%) for the study group and 695.8(533.71/76.7%) for the control group also with significant difference (P<0.05). Conclusion The modified sequential therapy containing levofloxacin mesylate is effective in eradicating H. pylori in the elderly patients and can be one choice of therapy.
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