慢性乙型肝炎伴萎缩性胃炎患者幽门螺旋杆菌感染序贯根除的疗效-论文.pdf

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1、临床消化病杂志2013年第25卷第5期·283·慢性乙型肝炎伴萎缩性胃炎患者幽门螺旋杆菌感染序贯根除的疗效朱金照，饶俊伟，吕勇，郑晶(福建医科大学附属传染病医院消化肝病科，福建福州，350025)摘要：目的探讨慢性乙型肝炎伴萎缩性胃炎患者幽门螺旋杆菌的感染率及序贯根除的临床效果。方法300例慢性乙型肝炎患者通过胃镜进行组织活检，病理证实为慢性萎缩性胃炎，均通过组织WS染色及14C．尿素呼气试验(UBT)检测幽门螺旋杆菌，其中195例阳性者随机分为治疗组105例和对照组90例，治疗组先给予雷贝拉唑+阿莫西林5d，随后给予雷贝拉唑+克拉霉素+甲硝唑5d，进行10d序贯治疗，对照

2、组给予传统三联既雷贝拉唑+克拉霉素+阿莫西林7d疗法，治疗结束4周后予14C—UBT复查。结果慢性乙型肝炎患者伴萎缩性胃炎幽门螺旋杆菌的感染率为65．0％，传统方法幽门螺旋杆菌的根除率约为70．O％，治疗组幽门螺旋杆菌的根除率达92．3％，两者比较，10d序贯疗法明显优于7d疗法(P<0．05)，两组副作用发生率无明显差异。结论慢性乙型肝炎伴萎缩性胃炎患者幽门螺旋杆菌的感染率较高，序贯治疗有较好的根除效果。关键词：慢性乙型肝炎：萎缩性胃炎：幽门螺旋杆菌；根除率[中图分类号]R574．51[文献标志码]A[文章编号]1005—541X(2013)05—283—03DOI：10

3、．3870／lcxh．j．issn．1005—541X．2013．05．10ClincalefectsofH．pylorieradicationwith10-daysequentialtherapyinpatientswithchronicatrphicgastritisandchronichepatitisBZHUdin·zha0．，Raojun-wei，LVyang，ZhengjinDepartmentofHepatal-Gastroenterology，FuzhouInfectiousDiseasesHospital，Fuzhou350025，ChinaAbstrac

4、t：ObjectiveTostudytheeffectsofH．pylorieradicationwith10一daysequentiNtherapyandtheinfectiousratesofH．pyloriingatiqntswithchronicatrophicgastritisandchronichepatitisB．Methods：Gastrtlmucosawasobservedbyelectricgastroscopein300casesofpatientswithchronichepatitisB，thepathologyofgastrumucosawere

5、studiedbybiopsyandatrophicgastritisconfirmedwere．195patientswithatrophicgastritisH．pylorimtectionwasprovedbyW—Stissuestainningandl4C—ureabreathtest(14C—UBT)Thepatientswererandomlydividedintotwogroups105patientswereadministeredwith10-daysequenti~therapyand90patientsreceived7一daystandardtrip

6、letherapy．14C—UBTwerereexamined4weeksafteracourseoftreatmenttoevaluatetheeradicationofH．pylori．ResultsIn300cases，H．pyloriwerepositivein195easesandthetotalpositiverateswere65％．TheH．pylorieradicationratesin10一daysequentialtherapygroupweresignificantlyhigherthanthosein7-daystandardtriplethera

7、pygroup(92．3％vs70％，P<0．05)．Theincidenceofadversereactionsin10一daysequen—tialtherapygroupand7一daytripletherapygroupwerenosignificantlydifference．ConclusionThepositiveratofH．pyloriwashigherinpa—tientswithchronicatrphicgastritisandchronichepatitisB，1O—daysequenti