链霉蛋白酶联合三联疗法对幽门螺杆菌根除率影响终.docVIP

链霉蛋白酶联合三联疗法对幽门螺杆菌根除率的影响 （第八届全国幽门螺杆菌感染及消化疾病诊治临床论坛优秀论文） 刘庆东（中国医科大学附属盛京医院，消化内科，辽宁省沈阳市，110004，现工作于陕西省榆林市第一医院消化内科） 李岩（中国医科大学附属盛京医院，消化内科，辽宁省沈阳市，110004） 目的 研究旨在探讨链霉蛋白酶联合三联疗法对幽门螺杆菌根除率的影响，寻求一种新型的根除方法并证实其疗效。收集2011年8月至2012年5月于我院门诊治疗的118例Hp阳性患者。所有患者治疗前均完成胃镜检查存在胃部或（和）十二指肠病变（胃溃疡、十二指肠溃疡、胃十二指肠溃疡和非溃疡性病变），行13C呼气试验检查阳性者，且来诊前均未做其他治疗。诊断明确后将符合入选标准的患者随机分为组60例和组58例。给予链霉蛋白酶颗粒联合三联疗法（埃索美拉唑20mg日次+阿莫西林1000mg 日次+左氧氟沙星0.5g日次）治疗；给予单纯三联疗法治疗。疗程均为10天。跟踪随访患者服药情况，治疗4周后复查13C呼气试验，观察Hp根除效果差异。组Hp阳性患者根除率为91.67%；组根除率为70.69%，两组统计学有差异性（P0.0）。链霉蛋白酶联合三联疗法能够有效提高幽门螺杆菌的根除率Efficacy evaluation of pronase combined with The Triple therapy for Helicobacter pylori eradication LIU QINGDONG，LI YAN(Digestive internal medicine,Research centre of Shengjing Affiliated Hospital of China Medical University, Shenyang, Liaoning（110004）【】 Object The purpose of this study was to explore the pronase combined with triple therapy for Hp eradication rate, to seek a new eradication method and to confirm its efficacy. Methods 118 Hp positive patients were admitted to our hospital from August 2011 to May 2012. All patients completed gastroscopy before treatment and confirmed gastric ulcer, duodenal ulcer, gastroduodenal ulcer and chronic gastritis with positive 13C breath test without any other treatment. They were randomly divided into two groups，roup A of 60 patients as treatment group which received pronase combined with the triple therapy (esomeprazole20mgBid+amoxicillin1000mg，bid+Levofloxacin 0.5gQd),and the other 58 cases as Group B received triple therapy only for 10 days. All patients were followed up,observed and received 13C breath test after 4 weeks to check the effects of Hp eradication. Results Two groups showed statistically differences (the eradication rates of group A was 91.67% and Group B was 70.69%, P 0.01). Conclusion The pronase combined with the triple therapy could effectively improve Hp eradication rate. 【Key words】 Pronase；Helicobacter pylori；Triple therapy 幽门螺杆菌(Helicobacter pylori，Hp)根除方案质子泵抑