以雷贝拉唑、左氧氟沙星为基础的三联补救疗法的临床观察 柏文霞王建 .doc

以雷贝拉唑、左氧氟沙星为基础的三联补救疗法的临床观察 柏文霞 王建宁 南京医科大学附属江宁医院消化科 211100 柏文霞：消化科硕士研究生，主治医师； 联系方式：邮箱zhuzuzu2121@;tel王建宁：消化科副主任医师 摘要： 目的：观察以雷贝拉唑、左氧氟沙星为基础的三联疗法对幽门螺杆菌根除失败的补救疗法的临床疗效。方法：幽门螺杆菌根除失败的患者50例，予雷贝拉唑20mg，阿莫西林1.0，一天两次；左氧氟沙星0.5，一天一次；口服一周。停药1个月后行13 C呼气试验检测来判断幽门螺杆菌根除率。结果: 49例完成了整个研究过程，意向处理分析(ITT)根除率为82.00%,完成治疗分析(PP)根除率为83.67%，总的副作用发生率为12.00％，症状缓解率95.92%。结论：以雷贝拉唑、左氧氟沙星为基础的短程三联疗法对根治失败的幽门螺旋杆菌感染患者是一种安全、有效的治疗方案。 关键词：幽门螺杆菌；三联疗法；补救治疗；雷贝拉唑；左氧氟沙星 The clinical efficacy of triple therapy with rabeprazole, levofloxacin-based as rescue therapy for Hp infection Wen-Xia Bai, Jian-Ning Wang Department of Gastroenterology, the Jiangning Hospital Affliated to Nanjing Medical University, Nanjing 211100, Jiangsu Province, China Abstract Objective：This study evaluated the clinical efficacy of a 1-week course of triple therapy with levofloxacin and amoxicillin plus rabeprazole as rescue therapy for H pylori infection in adults. Methods：Patients were received levofloxacin 500 mg QD and amoxicillin 1000 mg BID plus rabeprazole 20 mg BID for 1 week. H pylori status was determined 1 month after the end of therapy using a 13C urea breath test. Results: Of 50 consecutive patients screened for eligibility, 49 H pylori positive patients were enrolled in the study .Rates of H pylori eradication in the ITT and PP populations were as follows: 82.00% and 83.67%.The incidence of adverse reactions was 12.0% and remission rate was 95.92%. Conclusion：One week of rescue triple therapy with levofloxacin and amoxicillin plus rabeprazole was a safe, and effective treatment. Keywords：Helicobacter pylori；rabeprazole；levofloxacin; triple therapy；rescue therapy 1.前言 幽门螺杆菌(Helicobacter pylori ，Hp)感染是慢性活动性胃炎及消化性溃疡的重要致病因素，也与胃癌、胃黏膜相关淋巴瘤的发生密切相关。根除Hp对治愈消化性溃疡、预防溃疡复发、缓解胃炎症状、预防癌变有重要意义。近年来,虽然应用推荐的三联根除方案十分有效,但仍有近20%的患者根除治疗失败[1]。寻找有效的补救方案是目前临床所必须解决的问题，笔者在临床上使用雷贝拉唑、左氧氟沙星为基础的三联补救治疗方案，取得了较好的疗效。现介绍如下。 2.材料与方法 1）病例选择： 收集我院2010年3月一2011年3月消化科门诊Hp根除失败并符合人选标准的 H p感染患者50例，男性28例，女性22例，年龄18-70岁，平均年龄44.23岁。入选条件：( 1 )最近1个月内未使用过左氧氟