摘要
目的为评价不同药物治疗方案的疗效，观察幽门螺杆菌（Ｈｐ）根除与溃疡愈合，胃炎好转关系，进一步探讨Ｈｐ与十二指肠溃疡的关系。方法对４０例Ｈｐ阳性十二指肠溃疡患儿随机分三组，Ⅰ组（１０例）；雷尼替丁３ｍｇ·ｋｇ－１·ｄ－１×８周＋羟氨苄青霉素５０ｍｇ·ｋｇ－１·ｄ－１×４周，Ⅱ组（１５例）：雷尼替丁３ｍｇ·ｋｇ－１·ｄ－１×８周＋羟氨苄青霉素５０ｍｇ·ｋｇ－１·ｄ－１×４周＋次枸橼酸铋钾（ＣＢＳ）６ｍｇ·ｋｇ－１·ｄ－１×６周；Ⅲ组（１５例）：奥美拉唑１０ｍｇ×２周＋羟氨苄青霉素５０ｍｇ·ｋｇ－１·ｄ－１×４周。停药４周复查。结果三组溃疡愈合率分别为７００％，７１３％，９３３％；Ｈｐ转阴率分别为３００％，８６６％，１０００％；胃炎好转率分别为５００％，８８６％，８８６％。Ｈｐ转阴者溃疡愈合率９０３％，Ｈｐ仍阳性者溃疡愈合率９例中有４例，差异有显著性（Ｐ＜０．０５）。以铋剂治疗者血铋浓度９０４～１８．１２μｇ／Ｌ。结论Ｈｐ的存在影响溃疡愈合。雷尼替丁＋羟氨苄青霉素＋ＣＢＳ“三联”以及奥美拉唑＋羟氨苄青霉素“二联”疗法治疗Ｈｐ阳性十二指肠溃疡在溃疡愈合、Ｈｐ根除、胃炎好转均有较好疗效，而后者疗?
Objective To evaluate the efficacy of different drug therapies in treatment of duodenal ulcer (DU) and understand the relationship between eradicaton of Helicobacter pylori (Hp) and ulcer healing, and improvement of antral gastritis. Methods Fourty children with helicobacter pylori associated duodenal ulcer were treated respectively with, (1) ranitidine 3 mg·kg -1 ·d -1 for 8 weeks and amoxillin 50 mg·kg -1 ·d -1 for 4 weeks; (2)ranitidine 3 mg·kg -1 ·d -1 for 8 weeks and amoxillin 50 mg·kg -1 ·d -1 for 4 weeks and bismuth subcitrate (CBS) 6 mg·kg -1 ·d -1 for 6 weeks; (3) omeprazole 10mg for 2 weeks and amoxillin 50 mg·kg -1 ·d -1 for 4 weeks. The patients were followed up with endoscopic biopsies 4 weeks after each treatment course. Results The healing rates of the 3 groups were 70 0%,71 3%,93 3%, respectively, Hp eradication rates were 30 0%,86 6%,100 0% and the gastritis improvement rates were 50 0%,86 6%,86 6%. In the Hp eradicated patients, the ulcer healing was 90.3% while in those with Hp persistent infection 4/9 ( P <0.05). In 15 cases treated with CBS, serume bismuth concentration ranged from 9.04 μg/L to 18.12 μg/L. Conclusion The Hp eradication was associated with DU healing and gastritis improvement. Hp persistence may play a role in the recurrence of DU. Both the CBS triple therapy and the omeparazole double therapy were effective and safe; the latter was better tolerated.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
1998年第12期725-727,共3页
Chinese Journal of Pediatrics
