老年慢性肾功能不全患者与幽门螺旋杆菌感染相关性及临床治疗效果的观察
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摘要
目的:探讨老年慢性肾功能不全(CRF)患者与幽门螺旋杆菌(HP)感染相关性及临床治疗效果的观察。方法:选取150例老年CRF患者,将其纳入观察组,选择体检部的40名健康体检人员,将其纳入对照组。所有入组者均行快速~14C尿素呼气试验,诊断HP感染率。将150例老年CRF患者中的100例CRF合并HP感染患者,按照随机数表法将其分为序贯组与三联组,每组50例,分别进行序贯疗法以及常规三联治疗,连续治疗10 d后评价临床疗效,比较HP清除率以及症状积分,并进行肝肾功能检查,评价两组治疗安全性。结果:对150例老年CRF患者的观察组14C尿素呼气试验HP阳性108例,HP感染率为72.00%,显著高于对照组(32.50%),差异具有统计学意义(x~2=28.324,P<0.05)。序贯组HP清除率为98.00%,显著高于三联组(88.00%),序贯组治疗有效率为94.00%,显著高于三联组(84.00%),序贯组与三联组HP治疗有效率和清除率比较,差异有统计学意义(x~2=4.231,x~2=5.576;P<0.05)。序贯组与三联组治疗后腹胀、腹痛、嗳气以及纳差评分均显著降低,且序贯组显著低于三联组,其差异有统计学意义(t=12.432,t=1.223,t=10.276,t=9.326;P<0.05);序贯组与三联组治疗后肝、肾功能指标差异无统计学意义(t=12.432,t=1.223,t=10.276,t=9.326;P>0.05)。结论:老年CRF患者HP感染概率显著高于健康人群,对于CRF患者应进行常规幽门螺旋杆菌检测,而序贯疗法治疗HP感染疗效优于常规三联治疗,且治疗安全有效。
Objective: To investigate the correlation between chronic renal insufficiency(CRF) and helicobacter pylori(HP) infection in elderly patients and the relative clinical treatment effects. Methods: In this study, 150 elderly patients with CRF were selected as the observation group and 40 health individuals who were confirmed in the physical examination were selected as the control group. All of them underwent examination of ~14C-urea breath test(UBT) so as to diagnose the HP infection rate. 100 patients with CRF combined with HP infection in 150 elderly patients with CRF were divided into sequential treatment group(50 cases) and triple treatment group(50 cases) according to the random number table method. The two groups were implement sequential treatment and routine triple treatment, respectively, and the clinical effects of the two methods were evaluated after they were continuously treated 10 d. The clearance rate of HP and symptom score of the two methods were compared, and the safeties of the two methods were evaluated by the examining functions of liver and kidney. Results: The results of ~14C-UBT showed that the HP infection rate was 72%(108cases) in observation group, which was significantly higher than that(32.50%) in control group(x~2=28.324, P<0.05). The clearance rate of HP in sequential treatment group was 98.00%, which was significantly higher than that(88.00%) in triple treatment group, and the clinically effective rate in sequential treatment group was 94.00%, which was significantly higher than that(84.00%) in triple treatment group, and the differences of them was statistically significant(x~2=4.231, x~2=5.576, P<0.05). The scores of abdominal distension, abdominal pain, belching and anorexia of sequential treatment group were significantly lower than those of triple treatment group after treatment(t=12.432, t=1.223, t=10.276, t=9.326, P<0.05). Besides, the differences of indicators of liver and kidney function between sequential treatment group and triple treatment group after treatment were no significant(t=12.432, t=1.223, t=10.276, t=9.326, P<0.05). Conclusion: The incidence rate of HP infection in elderly patients with CRF is significantly higher than those of healthy people. For patients with CRF, routine HP detection should be carried out, moreover, compared with triple treatment, sequential treatment holds a more effective and safe therapeutic outcome.
Objective: To investigate the correlation between chronic renal insufficiency(CRF) and helicobacter pylori(HP) infection in elderly patients and the relative clinical treatment effects. Methods: In this study, 150 elderly patients with CRF were selected as the observation group and 40 health individuals who were confirmed in the physical examination were selected as the control group. All of them underwent examination of ~14C-urea breath test(UBT) so as to diagnose the HP infection rate. 100 patients with CRF combined with HP infection in 150 elderly patients with CRF were divided into sequential treatment group(50 cases) and triple treatment group(50 cases) according to the random number table method. The two groups were implement sequential treatment and routine triple treatment, respectively, and the clinical effects of the two methods were evaluated after they were continuously treated 10 d. The clearance rate of HP and symptom score of the two methods were compared, and the safeties of the two methods were evaluated by the examining functions of liver and kidney. Results: The results of ~14C-UBT showed that the HP infection rate was 72%(108cases) in observation group, which was significantly higher than that(32.50%) in control group(x~2=28.324, P<0.05). The clearance rate of HP in sequential treatment group was 98.00%, which was significantly higher than that(88.00%) in triple treatment group, and the clinically effective rate in sequential treatment group was 94.00%, which was significantly higher than that(84.00%) in triple treatment group, and the differences of them was statistically significant(x~2=4.231, x~2=5.576, P<0.05). The scores of abdominal distension, abdominal pain, belching and anorexia of sequential treatment group were significantly lower than those of triple treatment group after treatment(t=12.432, t=1.223, t=10.276, t=9.326, P<0.05). Besides, the differences of indicators of liver and kidney function between sequential treatment group and triple treatment group after treatment were no significant(t=12.432, t=1.223, t=10.276, t=9.326, P<0.05). Conclusion: The incidence rate of HP infection in elderly patients with CRF is significantly higher than those of healthy people. For patients with CRF, routine HP detection should be carried out, moreover, compared with triple treatment, sequential treatment holds a more effective and safe therapeutic outcome.
引文
[1]孙怡婕,陈颂春,孙敏,等.慢性肾衰方治疗老年慢性肾功能不全的临床观察[J].老年医学与保健,2016,22(5):286-288.
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[7]贺鸿杰.联合益生菌的三联疗法与序贯疗法对幽门螺旋杆菌根治疗效比较[J].中国医药导刊,2015,17(4):358-360.
[8]李芳芳,冯义朝.幽门螺杆菌感染的流行病学特点及其相关胃肠疾病的研究进展[J].当代医学,2015(11):11-12.
[9]Akpinar Z,Akay S,Unsal B.Improving the standard sequential treatment of Helicobacter pylori with either extended treatment or by adding bismuth[J].Arab J Gastroenterol,2017,18(2):58-61
[10]黄瑞,罗伟生.序贯疗法与传统标准三联疗法治疗幽门螺杆菌感染的Meta分析[J].中国中西医结合消化杂志,2016(6):481-483.
[11]信楠,杨培培,吕东勇,等.序贯疗法与标准三联疗法治疗幽门螺杆菌感染的随机对照试验[J].广州中医药大学学报,2015,32(2):220-225.
[12]Haimiao XU,Gastroenterology DO.Comparison of the Effect of Triple Therapy Combined with Probiotics and Sequential Therapy on Helicobacter Pylori Eradication[J].China Continuing Medical Education,2016,8(18):171-172.
[13]Mya SM,Myint T,Aung MM,et al.The efficacy of sequential treatment for Helicobacter Pylori eradication[J].ANN OPER RES,2015,90(90):293-322.
[14]朱国炼,林泽怀,王伟镇.10d序贯疗法与标准三联疗法根除幽门螺杆菌疗效比较[J].海南医学,2016,27(24):4011-4013.
[15]范洪起.10天序贯疗法根除幽门螺旋杆菌感染临床疗效分析[J].中国医药科学,2016,6(9):187-190.
[16]黄珏,宋冬霞.序贯疗法与三联疗法根除幽门螺杆菌的疗效比较[J].实用临床医药杂志,2015,19(5):114-116.
[2]Kale-Pradhan PB,Mihaescu A,Wilhelm SM.Fluoroquinolone Sequential Therapy for Helicobacter pylori:a Meta-analysis[J].Pharmac otherapy,2015,35(8):719-730.
[3]唐晓红,任敏,谭世桥.慢性肾功能不全患者幽门螺杆菌细胞毒素相关基因蛋白(CagA)的表达[J].华西医学,2002(1):52-53.
[4]孙妍,卢艳如.根除幽门螺杆菌在治疗老年慢性萎缩性胃炎中的临床意义[J].胃肠病学和肝病学杂志,2017,26(6):689-692.
[5]季红莉,付万发,陈明,等.老年患者幽门螺杆菌感染与胃炎活动性相关性分析[J].中华老年多器官疾病杂志,2016,15(6):447-450.
[6]Harmandar F,?likhan SU,üstüünda?n Y,et al.The efficacy of sequential therapy in eradication of Helicobacter pylori in Turkey[J].Niger J Clin Pract,2017,20(5):616-621.
[7]贺鸿杰.联合益生菌的三联疗法与序贯疗法对幽门螺旋杆菌根治疗效比较[J].中国医药导刊,2015,17(4):358-360.
[8]李芳芳,冯义朝.幽门螺杆菌感染的流行病学特点及其相关胃肠疾病的研究进展[J].当代医学,2015(11):11-12.
[9]Akpinar Z,Akay S,Unsal B.Improving the standard sequential treatment of Helicobacter pylori with either extended treatment or by adding bismuth[J].Arab J Gastroenterol,2017,18(2):58-61
[10]黄瑞,罗伟生.序贯疗法与传统标准三联疗法治疗幽门螺杆菌感染的Meta分析[J].中国中西医结合消化杂志,2016(6):481-483.
[11]信楠,杨培培,吕东勇,等.序贯疗法与标准三联疗法治疗幽门螺杆菌感染的随机对照试验[J].广州中医药大学学报,2015,32(2):220-225.
[12]Haimiao XU,Gastroenterology DO.Comparison of the Effect of Triple Therapy Combined with Probiotics and Sequential Therapy on Helicobacter Pylori Eradication[J].China Continuing Medical Education,2016,8(18):171-172.
[13]Mya SM,Myint T,Aung MM,et al.The efficacy of sequential treatment for Helicobacter Pylori eradication[J].ANN OPER RES,2015,90(90):293-322.
[14]朱国炼,林泽怀,王伟镇.10d序贯疗法与标准三联疗法根除幽门螺杆菌疗效比较[J].海南医学,2016,27(24):4011-4013.
[15]范洪起.10天序贯疗法根除幽门螺旋杆菌感染临床疗效分析[J].中国医药科学,2016,6(9):187-190.
[16]黄珏,宋冬霞.序贯疗法与三联疗法根除幽门螺杆菌的疗效比较[J].实用临床医药杂志,2015,19(5):114-116.