213例对阿莫西林及克拉霉素耐药幽门螺杆菌感染者治疗研究.docVIP

213例对阿莫西林及克拉霉素耐药幽门螺杆菌感染者治疗研究【摘要】 目的 对阿莫西林和克拉霉素耐药的幽门螺杆菌（Hp）感染者的治疗方案的疗效分析，并进行比较，寻找较为行之有效的治疗方案。方法 回顾性分析213例幽门螺杆菌感染者的不同治疗方案的治疗结果。入选患者分别接受质子泵抑制剂（咯赛克20mg,1次/d)＋左氧氟沙星胶囊(0．2,3次/d)+呋喃唑酮(0．1, 3次/d)和质子泵抑制剂（咯赛克20mg ,1次/d)＋甲硝唑（0．2, 3次/d)＋庆大霉素针(8万Ｕ, 3次/d,,口服)的两周治疗, 一月后内镜下复查快速尿素酶试验（胃窦、胃体两点）。结果 左氧氟沙星组Hp清除率为74．1％（83/112），甲硝唑组44．55%(45/101)，两组Hp清除率比较有显著性差异有统计学意义（P0．05）。结论 质子泵抑制剂（咯赛克20 mg ，1次/d)＋左氧氟沙星胶囊(0．2，3次/d)+呋喃唑酮(0．1，2次/d）杀菌率高，不良反应小，所以建议作为继克拉霉素组合之后的二线首选组合。? 【关键词】幽门螺杆菌；阿莫西林；克拉霉素；耐药；左氧氟沙星；呋喃唑酮?? The analyse of the effect to 213 patients infected by helicobacter palori Amoxicillin and Clarithromycin SHI Yu -ming.Department of Gastroenterology ，Wuxi BeiTang Hospital, Wuxi 214000, China ? 【Abstract】 Objective To analyse and compare the curative effect to 213 patients infected by helicobacter palori (Hp)that were unsuccessful treated by Amoxicillin and Clarithromycin that could be the better program． Methods`The patienrs were divided into 2 groups,one receiued Omeprazole losec, Levofloxacin,Furazolidone for two weeks,the other receiued of Omeprazole losec,Metronidazole Tablets ,Gentamycin Sulfate for two weeks．A Months later,all the patients examined Hp by the electron coronoscope.Results The Hp of 74．1％patients were eraticated in the Levofloxacin group,and the counterpart were only 44．55%． The statistics result show the significent diffirence between the two groups(P0．05 and 0．01) ConclusionThe effect ofOmeprazole losec, Levofloxacin,Furazolidone to the Hp was beffer than the Omeprazole losec,Metronidazole,Gentamycin Sulfate,so we sugest it was using Amoxicillin and Clarithromycin． ? 【Key words】Helicobacter palori; Amoxicillin;Clarithromycin;Drug resistance;Levofloxacin;Furazolidone ? 幽门螺杆菌感染者的治疗方案中质子泵抑制剂（PPI）＋阿莫西林＋克拉霉素三联疗法是最常用的标准方案。本文目的对阿莫西林和克拉霉素耐药的幽门螺杆菌感染者的治疗方案的疗效分析，并进行比较，寻找较为行之有效的治疗方案。? 1 资料与方法? 1．1 一般资料 病例来自本院2003年5月至2007年3月消化科和内镜室门诊及住院患者，C14呼气试验皆为阳性，经质子泵抑制剂＋阿莫西林＋克拉霉素三联疗法治疗2周，1月后复查C14呼气试验仍为阳性而入选。所有患者皆取得知情同意。? 1．2 方法 入选患者随机分为两组，Ａ组（112例）接受质子泵抑制剂（咯赛克2