幽门螺杆菌培养指导根除幽门螺杆菌治疗的研究
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摘要
目的观察根据幽门螺杆菌培养和药敏结果选择两种敏感抗生素加奥美拉唑三联一周疗法根除幽门螺杆菌根除率,旨在探讨幽门螺杆菌培养和药敏试验对根除幽门螺杆菌的指导作用。
方法选择经胃镜确珍的幽门螺杆菌阳性慢性胃炎和消化性溃疡患者120例,随机分为Hp培养组(40例)、OAM组(40例)和OAC组(40例)。幽门螺杆菌检测采用经胃镜胃黏膜活检标本快速尿素酶试验和组织学银染色法或~(14)C-尿素呼气试验。其中,Hp培养组:经胃镜取患者胃窦粘膜组织进行幽门螺杆菌培养和药敏试验,根据药敏结果选择两种敏感抗生素加奥美拉唑治疗,疗程一周;OAM组:奥美拉唑20mg、阿莫西林1.0、甲硝唑0.4,bid,疗程一周;OAC组:奥美拉唑20mg、阿莫西林1.0、克拉霉素0.5,bid,疗程一周;一月后检测幽门螺杆菌根除情况,观察Hp根除率,比较分析三组的差异。
结果Hp培养组、OAM组和OAC组的根除率分别为97.3%、76.3%和77.8%。Hp培养组与其他两组间Hp根除率差异均有统计学意义(P＜0.05),OAM组和OAC组间Hp根除率差异无统计学意义(P＞0.05)。
结论(1)根据药敏结果选择两种敏感抗生素加奥美拉唑三联一周疗法治疗Hp感染可获得较高的根除率。(2)幽门螺杆菌培养和药敏试验对幽门螺杆菌的根治有指导作用。
Objective To observe the efficacy of 1-week triple therapy of omeprazole and two antimicrobial agents by drug susceptibility test for helicobacter pylori eradication.,and to study the helicobacter pylori sensitivity of HP strains to antimicrobial agents,and to provide clinical evidence of choosing antimicrobial agents.
Methods One hundred and twenty patients with HP infection suffering from chronic gastritis and peptic ulcer were randomized to HP culture group,OAM group and OAC group.The HP culture group were administered omeprazole(20mg,twice a day)and two antimicrobial agents according to drug sensitivity test;OAM group were administered omeprazole(20mg,twice a day),Amoxicilin(1.0,twice a day ) and metronidazole(0.4, twice a day) for 1-week;OAC group group received omeprazole(20mg,twice a day), Amoxicilin(1.0,twice a day ) and clarithromycin(0.5,twice a day) for 1-week.Four weeks later,the HP eradication were observed.
Results The eradication rate among HP culture group,OAM group and OAC group were 97.3%、76.3%和77.7%,respectively.The difference of eradication rate between HP culture group and the other two groups was significant(P＜0.05),and there was no difference among OAM and OAC groups(P＞0.05).
Conclusions(1)l-week triple therapy of omeprazole and two antimicrobial agents according to helicobacter pylori culture and drug sensitivity test can enhance the HP eradication rate;(2) helicobacter pylori culture and drug sensitivity test can direct HP eradication therapy.
方法选择经胃镜确珍的幽门螺杆菌阳性慢性胃炎和消化性溃疡患者120例,随机分为Hp培养组(40例)、OAM组(40例)和OAC组(40例)。幽门螺杆菌检测采用经胃镜胃黏膜活检标本快速尿素酶试验和组织学银染色法或~(14)C-尿素呼气试验。其中,Hp培养组:经胃镜取患者胃窦粘膜组织进行幽门螺杆菌培养和药敏试验,根据药敏结果选择两种敏感抗生素加奥美拉唑治疗,疗程一周;OAM组:奥美拉唑20mg、阿莫西林1.0、甲硝唑0.4,bid,疗程一周;OAC组:奥美拉唑20mg、阿莫西林1.0、克拉霉素0.5,bid,疗程一周;一月后检测幽门螺杆菌根除情况,观察Hp根除率,比较分析三组的差异。
结果Hp培养组、OAM组和OAC组的根除率分别为97.3%、76.3%和77.8%。Hp培养组与其他两组间Hp根除率差异均有统计学意义(P＜0.05),OAM组和OAC组间Hp根除率差异无统计学意义(P＞0.05)。
结论(1)根据药敏结果选择两种敏感抗生素加奥美拉唑三联一周疗法治疗Hp感染可获得较高的根除率。(2)幽门螺杆菌培养和药敏试验对幽门螺杆菌的根治有指导作用。
Objective To observe the efficacy of 1-week triple therapy of omeprazole and two antimicrobial agents by drug susceptibility test for helicobacter pylori eradication.,and to study the helicobacter pylori sensitivity of HP strains to antimicrobial agents,and to provide clinical evidence of choosing antimicrobial agents.
Methods One hundred and twenty patients with HP infection suffering from chronic gastritis and peptic ulcer were randomized to HP culture group,OAM group and OAC group.The HP culture group were administered omeprazole(20mg,twice a day)and two antimicrobial agents according to drug sensitivity test;OAM group were administered omeprazole(20mg,twice a day),Amoxicilin(1.0,twice a day ) and metronidazole(0.4, twice a day) for 1-week;OAC group group received omeprazole(20mg,twice a day), Amoxicilin(1.0,twice a day ) and clarithromycin(0.5,twice a day) for 1-week.Four weeks later,the HP eradication were observed.
Results The eradication rate among HP culture group,OAM group and OAC group were 97.3%、76.3%和77.7%,respectively.The difference of eradication rate between HP culture group and the other two groups was significant(P＜0.05),and there was no difference among OAM and OAC groups(P＞0.05).
Conclusions(1)l-week triple therapy of omeprazole and two antimicrobial agents according to helicobacter pylori culture and drug sensitivity test can enhance the HP eradication rate;(2) helicobacter pylori culture and drug sensitivity test can direct HP eradication therapy.
引文
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