[泮托拉唑、克拉霉素和甲硝唑短期三联治疗根除幽门螺杆菌]。

Leber, Magen, Darm Pub Date : 1995-05-01
J Labenz, U Peitz, B Tillenburg, T Becker, G Börsch, M Stolte
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引用次数: 0

摘要

在一项前瞻性研究中,30例连续出现幽门螺杆菌阳性(组织学和/或培养)溃疡疾病的患者(n = 17;急性溃疡:n = 11)或功能性消化不良(n = 13),用泮托拉唑40 mg / d、克拉霉素250 mg / d和甲硝唑400 mg / d治疗1周以上。停用研究药物4周后,通过脲酶试验、培养和组织学评估幽门螺杆菌根除情况。一名患者在一天后因并发感染性疾病需要长期抗生素治疗而退出研究。另一名患者拒绝最后随访内窥镜检查。28名患者在没有违反方案的情况下完成了研究。28例患者中有24例幽门螺杆菌感染被根除(根除率:86%;95%置信区间:57%-96%)。溃疡患者比功能性消化不良患者更容易治愈细菌感染(94% vs 75%;P = 0.28)。在2例患者中,治疗失败与治疗前幽门螺杆菌对克拉霉素或甲硝唑的耐药有关。在根除治疗之外不进行抗溃疡治疗的情况下,10例可随访的患者中有9例在5周后经内窥镜证实溃疡愈合(治愈率:90%;95%置信区间:56%-100%)。7例患者报告轻度不良事件,但未导致停药(率:23%;95%置信区间:10%-42%)。感染治愈后,组织学显示胃窦炎和体胃炎的等级和活动度均有显著改善(p < 0.001)。(摘要删节250字)
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[Short-term triple therapy with pantoprazole, clarithromycin and metronidazole in eradication of Helicobacter pylori].

In a prospective study, thirty consecutive patients presenting with either H.pylori positive (histology and/or culture) ulcer disease (n = 17; acute ulcer: n = 11) or functional dyspepsia (n = 13) were treated over one week with pantoprazole 40 mg bd, clarithromycin 250 mg bd and metronidazole 400 mg bd. Four weeks after discontinuation of the study medication H.pylori eradication was assessed by means of an urease test, culture and histology. One patient had to be withdrawn from the study after one day because of a concomitant infectious disease requiring long-term antibiotic treatment. Another patient refused the final follow-up endoscopy. 28 patients completed the study without contravening the protocol. H.pylori infection was eradicated in 24 out of 28 patients (eradication rate: 86%; 95%-confidence interval: 57%-96%). Cure of bacterial infection was more frequently obtained in ulcer patients as compared to patients suffering from functional dyspepsia (94% vs 75%; p = 0.28). In 2 patients, treatment failure was associated with pretherapeutic resistance of H. pylori to either clarithromycin or metronidazole. Without antiulcer treatment beyond eradication therapy, ulcer healing was endoscopically confirmed after 5 weeks in 9 out of 10 patients available for follow-up (healing rate: 90%; 95%-confidence interval: 56%-100%). Seven patients reported mild adverse events that did not lead to discontinuation of the study medication (rate: 23%; 95%-confidence interval: 10%-42%). After cure of the infection, histology demonstrated a statistically highly significant improvement (p < 0.001) of both grade and activity of antrum and body gastritis.(ABSTRACT TRUNCATED AT 250 WORDS)

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[Diagnosis and therapy of portal hypertension]. [Diagnosis and therapy of Helicobacter pylori infection. Guidelines of the German Society of Digestive and Metabolic Diseases. Working Group of the German Society of Digestive and Metabolic Diseases]. [Positive effect of ursodeoxycholic acid on liver enzymes in autoimmune hepatitis with little activity--a pilot study]. [Aortoduodenal fistula as the cause of gastrointestinal hemorrhage]. [Pseudo-esophagitis in antacid abuse].
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