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1.
目的观察根除幽门螺杆菌治疗对高原地区幽门螺杆菌相关性溃疡病患者血清IL-1β、IL-2、IL-4、IL-6、IL-8和TNF水平的影响,以探讨其在溃疡病发病中的可能致病机理。方法应用放射免疫法测定55例溃疡病患者血清6种细胞因子的含量,比较幽门螺杆菌感染与非感染患者含量的差异,对幽门螺杆菌感染患者进行以洛赛克为中心的三联1周疗法,比较根除前后及根除者和未根除者其含量的差异,同时比较幽门螺杆菌根除组和未根除组溃疡的愈合率。结果55例患者中,幽门螺杆菌感染者30例,感染者血清IL-4含量明显低于非感染者(P<0.01),幽门螺杆菌根除后其含量极明显高于根除前(P<0.001),未根除者前后比较无变化(P>0.05),根除者明显高于未根除者(P<0.05),而根除幽门螺杆菌治疗对IL-1β、IL-2、IL-6、IL-8和TNF均无显著性影响(P>0.05),幽门螺杆菌根除组溃疡愈合率明显高于未根除组(P<0.05)。结论幽门螺杆菌感染后IL-4降低导致的Th2免疫应答下调可能是幽门螺杆菌相关性溃疡病发生的主要致病机制之一;根除幽门螺杆菌可使IL-4分泌明显增加,Th2免疫应答上调,从而加速溃疡愈合;血清IL-4的检测有望成为根除幽门螺杆菌和溃疡愈合疗效判定的有用指标。  相似文献   

2.
血清幽门螺杆菌抗体检测在儿童再发性腹痛中的应用   总被引:1,自引:0,他引:1  
蒋海珍 《山东医药》2008,48(13):77-77
检测200例5周岁以上再发性腹痛(RAP)患儿血清幽门螺杆菌抗体(Hp-IgG),并对Hp-IgG阳性患儿行14C尿素呼气试验("C-UBT)检查.结果 RAP患儿中Hp-IgG阳性率为41.0%;男性高于女性,但无统计学差异(P>0.05);学龄前儿童Hp-IgG阳性率为10.0%,学龄儿童为31.0%,二者比较有统计学差异(P<0.05).Hp-IgG阳性患儿行14C-UBT检查的阳性率为87.8%.认为血清Hp抗体检测适合于儿童RAP的Hp感染检查.  相似文献   

3.
儿童再发性腹痛与幽门螺杆菌感染的关系   总被引:1,自引:0,他引:1  
唐泓 《山东医药》2007,47(32):135-135
儿童是感染幽门螺杆菌(Hp)的高危时期,为探讨儿童再发性腹痛(RAP)与Hp感染的关系,我们对366例RAP儿童进行^13C尿素呼气试验检查,了解本病患儿的Hp感染率。现报告如下。  相似文献   

4.
目的探讨幽门螺杆菌感染慢性胃炎中西医结合治疗的疗效。方法选取2014年12月~2015年8月我院收治的幽门螺杆菌感染慢性胃炎患者80例作为研究对象,分为对照组与观察组,各40例。观察组执行中西医结合治疗方法,对照组执行西医三联治疗方法。比较两组患者根除门螺杆菌率、慢性胃炎疗效、不良反应与复发率。结果根除患者幽门螺杆菌率观察组为92.5%,显著高于对照组的65%,差异有统计学意义(P0.05);总有效率观察组为95%,显著高于对照组的70%,差异有统计学意义(P0.05);幽门螺杆菌感染复发率观察组为2.5%,显著低于对照组的12.5%,差异有统计学意义(P0.05)。结论与单纯的西医治疗方法对比,中西结合治疗的疗效更加明显,复发率不高,值得推广。  相似文献   

5.
3368例武汉市儿童幽门螺杆菌感染的临床分析   总被引:1,自引:1,他引:0  
目的了解武汉市有消化道症状的儿童幽门螺杆菌感染状况、分布特征及影响因素。方法选取我院及武汉市医院2010年8月~2011年7月3 368例有消化道症状的儿童,以性别和年龄进行分组,通过14 C-尿素呼气试验检测幽门螺杆菌感染情况,并对其结果进行统计学分析,同时对这些儿童的生活方式进行问卷调查分析。结果 3 368例受检儿童H.pylori总感染率为29.2%,其中男女儿童H.pylori感染阳性率分别为29.2%和29.1%,男女儿童H.pylori感染阳性率差异无统计学意义(P>0.05);学龄前、学龄期及青春期儿童H.pylori感染阳性率分别为27.1%、28.7%和39.1%,学龄前期与学龄期H.pylori感染阳性率差异无统计学意义(P>0.05),学龄前期、学龄期与青春期H.pylori感染阳性率差异有统计学意义(P<0.01);年龄与H.pylori感染阳性率相关(P=0.001);同年龄组男女儿童H.pylori感染阳性率差异无统计学意义(P>0.05);父母幽门螺杆菌阳性患儿幽门螺杆菌阳性率57.5%。结论武汉市有消化道症状的儿童幽门螺杆菌感染率高,随年龄增长感染率递增,但与性别无关,父母幽门螺杆菌阳性患儿幽门螺杆菌阳性率高,年龄、家庭聚集性、父母H.pylori感染与儿童H.pylori感染相关。  相似文献   

6.
药敏试验指导根除幽门螺杆菌治疗的临床研究   总被引:1,自引:0,他引:1  
目的 观察根据药敏结果选择两种敏感抗生素加奥美拉唑三联1周疗法治疗幽门螺杆菌(Hp)的根除率,探讨幽门螺杆菌药敏试验对根除幽门螺杆菌的指导作用.方法 选择经胃镜确诊的幽门螺杆菌阳性慢性胃炎和消化性溃疡患者120例,将120例患者分为三组,各40例.Hp培养组:经胃镜取患者胃窦黏膜组织进行幽门螺杆菌培养和药敏试验,根据药敏结果选择两种敏感抗生素加奥美拉唑治疗,疗程1周;OAM组:奥美拉唑20 mg、阿莫西林1.0、甲硝唑0.4,每天2次,疗程1周;OAC组:奥美拉唑20 mg、阿莫西林1.0、克拉霉素0.5,每天2次,疗程1周;一个月后检测幽门螺杆菌根除情况,观察Hp根除率.结果 Hp培养组、OAM组和OAC组的根除率分别为97.3%、76.3%和77.8%.Hp培养组与其他两组问Hp根除率比较差异均有显著性(P<0.05),OAM组和OAC组间Hp根除率比较差异无显著性(P>0.05).结论 根据药敏结果选择两种敏感抗生素加奥美拉唑三联1周疗法治疗Hp感染可获得较高的根除率,是根除Hp的理想方案;幽门螺杆菌药敏试验对临床幽门螺杆菌菌株的根治有指导作用.  相似文献   

7.
[目的]:观察胃力康配合奥美拉唑三联疗法治疗幽门螺杆菌(Hp)阳性消化性溃疡的疗效。[方法]选取2012年1月~2014年1月期间我院接收治疗的108例幽门螺杆菌阳性消化性溃疡患者。采用随机数表法将108例患者分为观察组和对照组,各54例。2组患者均给予20mg奥美拉唑+1.0g阿莫西林+0.5g克拉霉素进行治疗,疗程为2周。观察组患者加服10g胃力康,疗程为4周。对比2组患者的临床疗效、症状缓解率、药物不良反应上报率、Hp根除率及6个月后溃疡复发情况。[结果]观察组患者的临床总有效率为95.28%显著高于对照组患者的81.49%,比较2组间差异具有统计学意义(P0.05)。2组患者治疗后腹胀、腹痛、反酸、嗳气、恶心等症状的缓解病例数与缓解率比较差异无统计学意义(P0.05)。观察组患者治疗后Hp根除率及6个月后溃疡复发率分别为94.44%、3.70%,对照组患者治疗后Hp根除率及6个月后溃疡复发率分别为81.48%、11.11%,比较2组间差异有统计学意义(P0.05)。观察组患者治疗后药物不良反应上报率为7.40%较对照组患者的9.25%差异无统计学意义(P0.05)。[结论]胃力康配合奥美拉唑三联疗法治疗幽门螺杆菌阳性消化性溃疡的临床疗效肯定且复发率较低,可以在临床上进一步推广和使用。  相似文献   

8.
目的比较含复方尿囊素四联疗法与含铋剂四联疗法对幽门螺杆菌感染(H.pylori)慢性胃炎的效果。方法 84例H.pylori感染慢性胃炎患者随机分为两组,每组42例。对照组给予含铋剂四联疗法,观察组给予复方尿囊素四联疗法,两组均治疗10 d。对两组H.pylori根除率、胃肠道症状缓解率、血清C-反应蛋白、不良反应进行观察。结果观察组H.pylori根除率为92.9%,对照组H.pylori根除率为90.5%,两组比较差异无统计学意义(P>0.05)。观察组腹痛、腹胀、嗳气缓解率分别为80.6%、78.1%、75.0%,略高于对照组之79.4%、70.0%、73.1%,但两组差异无统计学意义(P>0.05)。观察组C-反应蛋白水平为(3.71±1.26)mg/L,对照组C-反应蛋白水平为(3.59±1.38)mg/L,两组比较差异均无统计学意义(P>0.05)。两组均未出现严重不良反应。结论含复方尿囊素四联疗法对H.pylori有较好的根除效果,并能有效缓解患者临床症状,效果与含铋剂四联疗法相当。  相似文献   

9.
目的探讨三联疗法治疗老年幽门螺杆菌阳性消化性溃疡患者的最佳时效。方法选取100例老年幽门螺杆菌阳性消化性溃疡患者作为研究对象,采用随机数字表法将100例患者分为三组,患者均采用奥硝唑、雷贝拉唑和铝碳酸镁标准三联方案,每日用药两次。组1患者服药7 d,组2患者服药10 d,组3患者服药14 d。观察并比较三组患者的幽门螺杆菌根除率、溃疡愈合率以及不良反应发生情况。结果三组患者幽门螺杆菌根除率比较有统计学差异(均P0.05),组1显著低于组2和组3(均P0.05),组2和组3比较无统计学差异(P0.05)。三组患者的溃疡愈合率比较无统计学差异(P0.05)。组1、2不良反应发生率明显低于组3(均P0.05);组1和组2比较无统计学差异(P0.05)。结论三联疗法10 d疗程是治疗老年幽门螺杆菌阳性消化性溃疡的较好实验方案。  相似文献   

10.
目的探讨分析山东济宁地区自然人群幽门螺杆菌的流行病学特征,为防治提供参考。方法于2012-05/2013-05采集山东济宁市第一人民医院胃镜室就诊患者580例,采用14C-UBT检测法与血清幽门螺杆菌Ig G抗体ELISA法对所有研究对象的幽门螺杆菌感染情况进行检测,并结合相关问卷调查,分析其流行病学特征。结果该医院门诊患者幽门螺杆菌总感染率45.2%,其中男性感染率59.5%,女性感染率40.5%,不同性别感染幽门螺杆菌感染阳性率差异比较无统计学意义(P0.05);各年龄段幽门螺杆菌的感染率从31.4%~53.1%不等,农民、商人及工人幽门螺杆菌感染率分别为78.6%、70.7%、68.8%,高于其他职业,差异有统计学意义(P0.05),但各年龄段间幽门螺杆菌感染率的差异比较无统计学意义(P0.05)。幽门螺杆菌感染与吸烟、饮酒、家庭收入无关,差异无统计学意义(均P0.05),与个人饮食卫生习惯、家庭教育程度及职业有关,差异有统计学意义(P0.05)。结论山东济宁市某医院门诊患者幽门螺杆菌总感染率较高,其感染率与职业、个人及家庭生活习惯等有关。  相似文献   

11.
The study involved a dynamic comparative efficacy survey of the standard triple and quadruple therapies recommended by the Maastricht Consensus as first line therapies for eradication of Helicobacter pylori infection with the time period of 5 years. The study included 199 Hp-positive patients with stomach ulcer; 101 of them were under examination in 1997 and 98 in 2002. Depending on the therapy type, patients were assigned to one of two groups: the OCM/A group (48 and 53 patients in 1997 and 2002, respectively) was treated with Omeprazole, Clarithromycin and Metronidazole for 7 days and ODTM group (46 and 52 patients in 1997 and 2002, correspondingly) was treated with Omeprazole, De-Nol, Tetracycline and Metronidazole. To discover and confirm Hp eradication, cytological, histological and rapid urease tests were used. Hp eradication was considered as successful when all the tests were negative. The eradication frequency was assessed with the help of ITT and PP analyses. In the OCM/A group Hp was eradicated in 81.3% and 62.3% (p<0.05) of patients when analyzed by the intention-to-treat and in 88.6% and 66.0% (p<0.01) of patients when analyzed by per-protocol in 1997 and 2002, respectively. In the ODTM group Helicobacter pylori was eradicated in 89.1% and 88.5% (p<0.05) of patients when analyzed by intention-to-treat and 95.3% and 93.9% (p<0.05) when analyzed by per-protocol in 1997 and 2002, respectively. The frequency of ulcer cicatrisation and cuticularization of erosions did not depend on the type of the treatment. There was no significant difference between the compliance and side effects of the triple and quadruple therapies. Taking into account the decrease in the efficacy of the triple anti-Hp therapy, the need to use the quadruple therapy as a first line therapy for Hp infection eradication was substantiated.  相似文献   

12.
目的 探讨老年消化性溃疡发生、复发与幽门螺杆菌 (Hp)感染的关系。方法 应用 PCR法对 78例老年性消化性溃疡幽门螺杆菌感染及幽门螺杆菌感染根除治疗后半年、 1年幽门螺杆菌再感染者进行了测定。结果 幽门螺杆菌检出率老年组明显高于青年组 ,Hp根治率青年组明显高于老年组 ,经 Hp根除治疗组溃疡愈合率明显高于未根除治疗组。结论 老年消化性溃疡发生与幽门螺杆菌感染密切相关 ,在溃疡治疗中 ,根除 Hp感染对减少溃疡复发具有重要临床意义  相似文献   

13.
目的 :观察胃舒散、呋喃唑酮和阿莫西林对幽门螺杆菌 (Hp)阳性十二指肠溃疡 (DU)的疗效及根除Hp对溃疡复发的影响。方法 :73例 Hp阳性 DU患者随机分为两组 :三联组 4 1例 ,服用胃舒散 2 .0 g,呋喃唑酮 0 .1g,阿莫西林 0 .5 g,各 3次 /d ,2周后再继服胃舒散 4周。雷尼替丁组 32例 ,服用雷尼替丁 0 .15 g,3次 /d,共 6周。治疗前后均记录胃痛症状 ,内镜观察溃疡情况 ,并进行 2年随访。Hp检测采用 Warthin- Starry银染色法 ,1 4C-尿素呼气试验或快速尿素酶试验 ,2项阳性为 Hp感染 ,阴性为 Hp根除。结果 :6周治疗结束后 ,两组溃疡愈合率均为10 0 %。三联组临床症状缓解率、副反应发生率为 97.6 %和 18.8% ,雷尼替丁组为 93.8%和 9.4 % (均 P >0 .0 5 )。三联组 Hp根除率 (92 .7% )显著高于雷尼替丁组 (0 % ,P <0 .0 1)。 Hp根除的 38例中 ,1年及 2年溃疡复发率为(5 .3% ,10 .5 % )均显著低于 Hp持续感染者 (2 8.1% ,4 6 .9% ,P <0 .0 1)。结论 :以胃舒散为主的三联疗法具有疗效高、副作用少、溃疡复发率低的优点 ,是一种根除 Hp的较好方案。  相似文献   

14.
BACKGROUND AND AIM: The causal relationship between Helicobacter pylori infection and recurrent abdominal pain in children is still under debate. This study assessed the relationship between H. pylori infection and recurrent abdominal pain (RAP) in preschool and school children. METHODS: A total of 1271 preschool and school children completed a questionnaire to define the RAP or short-term RAP (SRAP) with pain duration from 2 weeks to 3 months. The serum samples of 118 children with RAP, 60 with SRAP and 212 control children without abdominal pain were all tested for anti-H. pylori IgG. Children with abdominal pain and anti-H. pylori seropositivity were followed for 1 year to assess the relationship of H. pylori infection and recurrent abdominal pain. RESULTS: The prevalence rates of RAP and SRAP in children were 9.8% (124/1271) and 5.5% (70/1271), respectively. Children with SRAP had a higher anti-H. pylori seropositive rate than those with RAP (25%vs 5%, P < 0.001) and control (25%vs 9%, P = 0.001). Among children with SRAP, the epigastric pain was related to H. pylori infection (P = 0.002). One year later, 71% (15/21) of the follow-up children (15 with SRAP, six with RAP) became symptom free regardless of the persistence of H. pylori. CONCLUSION: H. pylori infection is more commonly found in children with short-term RAP, and presentation of epigastric pain in these cases can be considered as a warning alarm to screen for H. pylori infection.  相似文献   

15.
目的:前瞻性追踪观察经内镜气囊扩张和根除幽门螺杆菌(Hp)对十二指肠球部溃疡(DU)所致幽门梗阻的远斯疗效。方法:对25例DU合并幽门梗阻者给予气囊扩张和四联方案根除Hp治疗,且随访在12月以上者进入统计分析。Hp感染用尿素酶、组织学和全血抗体测定。Hp是否根除用~(14)C尿素呼气试验。结果:25例均成功经内镜气囊扩张而无并发症。最后气囊直径:11例12mm,10例15mm,4例18mm。21例(84.0%)行根除Hp治疗均成功根除Hp,4例Hp阴性者而未行根除治疗。平均随访34月。Hp根除者梗阻复发率4.7%(1/21),显著低于未行根除治疗的复发率50.0%(2/4)(P<0.05)。结论:气囊扩张和根除Hp治疗DU导致的幽门梗阻可获得较好的远期效果。  相似文献   

16.
背景:全球约半数人群存在幽门螺杆菌(Hp)感染,根除Hp是治疗其感染相关疾病的重要方法。目的:分析Hp根除前后部分肠道菌群的改变,探讨铋剂四联疗法对肠道微生态的影响。方法:纳入2016年1月—2017年1月在深圳市第三人民医院发现Hp感染阳性、接受铋剂四联疗法根除治疗并成功根除Hp的个体,采集其Hp根除前和根除治疗结束后3 d内的粪便标本,提取基因组DNA,采用菌属特异性引物行real-time PCR定量分析。结果:与根除前相比,Hp根除后粪便肠杆菌属、肠球菌属数量明显增加,双歧杆菌属、拟杆菌属、梭菌属和总菌数量明显减少,差异均有统计学意义(P<0.05),乳酸杆菌属数量无明显变化(P>0.05)。结论:采用铋剂四联疗法根除Hp可影响肠道菌群结构,导致肠道微生态失衡。  相似文献   

17.
13C-urea breath test,referral patterns,and results in children   总被引:3,自引:0,他引:3  
BACKGROUND: The family is the core unit for Helicobacter pylori (Hp) infection. In most instances, Hp colonization occurs in early childhood, and correlates with socioeconomic parameters. Helicobacter pylori infection is highly prevalent in many countries, and may cause chronic gastritis and peptic ulcer in adults and in children. Gastritis induced by Hp may be associated with recurrent abdominal pain in children, and eradication of the bacterium may improve the clinical symptoms.AIM The primary aim of this study is to characterize the group of pediatric patients according to the referral patterns and results of 13C-urea breath test (13C -UBT) in our laboratory. The secondary aim is to investigate the result of different treatment combinations for Hp eradication. METHODS: The 13C-UBT was performed with 75 mg urea labeled with 13C in 200 mL orange juice. Breath samples were collected at 0 and 30 minutes, and the results expressed as the change in the 13C/12C ratio at T30' minus T0' The cutoff for Hp eradication was 3.5. The physicians who ordered the test completed a questionnaire covering demographic data (age, gender, and origin), indication for the test was use of a proton pump inhibitor (PPI), and type of combination eradication therapy. RESULTS: The study sample consisted of 1655 children, aged 1 to 18 years, 992 (59.9%) boys and 663 (40.1%) girls, from all parts of the country. The 13C-UBT was positive in 763 (46.1%). The prevalence of positive results was directly correlated with age. History of peptic disease was the main indication for the test, in 1346 (81.4%) cases. Details on eradication therapy were available for 435 children of whom 42.5% had a positive 13C-UBT, indicating a successful eradication rate of 57.5%. Compared with Israeli and American-European origin, children of Asian-African origin had a higher rate of referrals for reason of validation of successful Hp eradication, greater long-term PPI use, and a higher rate of 13C-UBT positivity. No significant difference was demonstrated between the triple therapy regimens used. CONCLUSION: 13C-UBT may be performed in children of all age groups. The main indication is a history of peptic ulcer disease. The prevalence of Hp infection increased with age and the only factor associated with increased Hp infection was Asian-African origin. The most frequent eradication therapy used in children is a combination of omeprazole, amoxicillin, and clarithromycin.  相似文献   

18.
目的 探讨单纯收缩期高血压(ISH)患者血浆半胱氨酸水平及血脂在药物根除幽门螺杆菌(HP)感染后的动态变化。方法 48例有HP感染的ISH患者在用胶体次枸桶酸铋+阿莫西林+甲硝唑(三联疗法)治疗前、治疗2百及停药4周后,分别测定血浆胆固醇(TC)、甘油三酯(TG)、总半胱氨酸(tHey)、维生素B12、叶酸脏一氧化氮(NO)水平,并与48例按年龄及性别配对的健康对照者(服安慰剂)比较。结果 ISH  相似文献   

19.
特发性血小板减少性紫癜与幽门螺杆菌感染的相关性研究   总被引:1,自引:0,他引:1  
何晖  翟明 《中国实用内科杂志》2007,27(20):1633-1634
目的研究特发性血小板减少性紫癜(ITP)与幽门螺杆菌(Hp)感染的相关性,观察抗Hp治疗对难治性ITP的疗效。方法对中国医科大学附属第一医院血液科2002年11月至2005年5月收治的48例ITP患者进行研究,正常对照组52例,因消化系统症状行胃镜和其他相关检查但未见明显异常的门诊患者。采用13C-尿素呼气试验及Hp血清抗体联合诊断Hp感染。对11例Hp感染阳性的难治性ITP患者抗Hp治疗,采用经典的三联药物,具体为奥美拉唑20mg口服,每日2次;克拉霉素500mg口服,每日2次;阿莫西林1g口服,每日2次,连用7d,4~8周后复查13C-尿素呼气试验、Hp血清抗体、血小板计数和血小板抗体。结果ITP组和正常对照组的Hp感染阳性率分别为68.18%(33/48),46.12%(24/52),ITP组Hp阳性率显著升高(P<0.05);11例常规治疗无效或复发患者并伴有Hp感染,有8例经上述治疗Hp感染转为阴性,该8例4~8周后血小板计数显著升高,其中6例血小板自身抗体消失,而Hp检测阴性患者和Hp感染未得以根治的患者随访时血小板抗体和血小板计数均无变化。结论ITP患者Hp感染阳性率高于正常人;对于Hp感染阳性的难治性ITP患者,根除Hp的方法治疗ITP是行之有效的。  相似文献   

20.
BACKGROUND: Controlled trials considering the effect of Helicobacter pylori (H. pylori) eradication on gastrointestinal symptoms in children are scant. We aimed to study the connection between recurrent abdominal pain and dyspepsia and H. pylori infection in children. STUDY: This was a double blind randomised controlled trial. Twenty children with recurrent abdominal pain (RAP) being H. pylori positive as measured with the C urea breath test (UBT) were randomized either to receive omeprazole, amoxycillin and clarithromycin (n = 10), or omeprazole and 2 placebos (n = 10) for 1 week after gastroscopy. Symptoms were registered prior to the treatment and at follow up visits 2, 6, 24, and 52 weeks after stopping the treatment. Control UBT was performed on all patients 6 weeks post-treatment and again at the 52 week follow-up visit, when also re-endoscopy with biopsies was done to all participants. RESULTS: All infected children had histologic gastritis. Bacterial eradication was achieved in 8/10 in the triple treatment group and in none in the placebo group. There was no change in symptom index in either group at 2 weeks post treatment. At 52 weeks a similar reduction in symptom index was observed in both groups irrespective of the healing of gastritis, which was more commonly achieved along the eradication. CONCLUSIONS: Bacterial eradication and healing of gastric inflammation does not lead to symptomatic relief of chronic abdominal pain in children.  相似文献   

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