三种三联疗法对HP阳性的消化性溃疡的疗效和治疗成本的比较

本研究比较了三种三联疗法对HP阳性的消化性溃疡(Pu)的疗效和治疗成本。59例病人经内镜确诊为PU，组织学和(或)^12C(或^14C)呼吸试验证实HP阳性，随机进入三种低剂量三联根除方案。所有病人在治疗开始后第六周复查内镜并作组织学检查和(或)^13C(或^13C)呼吸试验以评价溃疡愈合和HP根除情况。结果表明：方案3(雷尼替丁0．15Bid 灭滴灵0．2Qid 羟氨苄青霉素0．25Qid连用两周，续用雷尼替丁0．15Bid两周)的溃疡愈合率HP根除率和副反应发生率分别为95．2%、85．7%，14．3%，均优于另两方案(方案1：次枸橼酸胶态铋（CBS）120mg Qid 灭滴灵0．2Qid 四环素0．25Qid，连用两周．方案2：同方案1，仅以羟氨苄青霉素0．25Qid代替四环素)，但治疗成本略高。三种方案的上述指标的差异均无显性(P＞0．05)。     

幽门螺旋杆菌相关性胃炎的药物疗效比较

用羟氨苄青霉素,灭滴灵,胃必治、甲氰咪胍及安慰剂治疗106例幽门螺旋杆菌相关性胃炎(HPAG),疗程2周.上述药物的幽门螺旋杆菌(HP)清除率依次为60.9%、40.0%、23.8%、4.6%及0%.羟氨苄青霉素组和灭滴灵组的HP 清除率与安慰剂组比较有明显差异(P<0.05),而胃必治组和甲氰咪胍组与安慰剂组比较却无显著差异(P>0.05).胃炎好转率与HP 清除率完全一致,羟氨苄青霉素组最高(65.2%),灭滴灵组次之(40.0%),胃必治组(19.1%)及甲氰咪胍组(4.6%)无效.本文尚对胃必治疗效差的原因作了扼要讨论.     

雷尼替丁与羟氨苄青霉素及甲硝唑合用治疗十二指肠溃疡和根除幽门螺杆菌

我们对51例确诊幽门螺杆菌(HP)感染的活动性十二指肠溃疡患者给予雷尼替丁150mg,每日2次,共28天,羟氨苄青霉素500mg,每日3次,及甲硝唑400mg,每日2次,共14天治疗,于第6周复查胃镜、活检组织学、尿素酶试验和~(13)C 尿素呼吸试验,以鉴定溃疡愈合和 HP 根除情况。结果:HP 根除率88.2%,溃疡愈合率88.2%,副反应很小,显示本疗法是值得推荐的方案。     

低剂量三联疗法根除幽门螺杆菌的临床研究

三联疗法至今仍然是根除幽门螺杆菌疗效最佳的治疗方案,但副反应大.根据国人体质,本研究将原方案剂量减低,即德诺(迈特药厂产)120mg每日4次,灭滴灵0.2每日4次,四环素0.25每日 4次,三药同服两周.继德诺240mg每日2次,再服2周.对象为HP阳性的十二指肠球部溃疡共43例.于治疗前及停药12周作胃镜检查,取胃窦、体粘膜活检     

根除幽门螺旋菌对胃液中抗坏血酸浓度的影响

抗坏血酸由正常胃分泌,能防止胃癌的是维生素C的还原形式,在幽门螺旋菌(HP)相关的慢性胃炎其分泌减少。本研究观察根除HP能否使胃液中抗坏血酸值增高。 方法:十二指肠溃疡(DU)者服用一周胶性次枸橼酸铋120mg qid或胶性次枸橼酸铋120mg加氨苄青霉素500mg qid和灭滴灵400mg tid。肠腺化生(IM)者随机服用二周安慰剂或胶性次枸橼酸铋120mg qid加土     

雷尼替丁三联疗法对幽门螺杆菌阳性十二指肠溃疡的近期及远期疗效

对82例幽门螺杆菌(HP)阳性的十二指肠溃疡用雷尼替丁、羟氨苄青霉素和甲硝唑三联疗法2周,追踪1年,并与145例铋剂三联疗法病例对照。结果治疗组溃疡愈合率87.8%,HP根除率89.0%;对照组两参数为92.4%和85.7%(P均＞0.05)。治疗组副反应显著少。追踪1年,治疗组HP感染再燃9例(12.3%),重感染2例(2.7%),溃疡复发率HP阴转组1/61(1.6%),HP阳性组7/11(63.6%)(P＜0.01)。因再燃率高且在停药后4~8周发生,建议修定HP根除的标准时间,应从4周末延到8周末。     

一种不用灭滴灵治疗幽门螺旋菌感染的新疗法——克拉霉素、四环素和铋剂

灭滴灵、铋剂和四环素三联疗法是目前治疗幽门螺旋菌(HP)感染的最好方法。但灭滴灵的抗药性越来越明显,故严重限止了此种三联疗法的使用。克拉霉素是一种新的大环内酯类抗生素,在体外有良好的抗HP活性,并已证明其单独使用及与奥美拉唑合用时均相当有效。本试验评估克拉霉素在替代传统三联疗法中灭滴灵时的抗HP作用。     

四联疗法治疗幽门螺杆菌阳性十二指肠溃疡患者的成本-效果分析

幽门螺杆菌(Hp)是消化性溃疡的重要致病因子，根除Hp可明显减少溃疡的复发率。为探索安全、价廉、疗效好的治疗方案，我们观察了雷尼替丁、果胶铋、羟氨苄青毒素和甲硝唑组成的四联方案对十二指肠溃疡合并HP感染的疗效，并与奥美拉唑、羟氨苄青毒素和甲硝唑三联方案进行费用效益比较。     

含低剂量克拉霉素四联根除幽门螺杆菌相关性胃炎的临床研究

1990年在悉尼召开的世界胃肠病大会及其后一些会议共识中，以铋剂为主的三联(其中两种抗生素常为羟氨苄青霉素、甲硝唑、四环素、痢特灵)14天疗法被专家们推荐为根除幽门螺杆菌(Helicobacter pylori．简称Hp)的方案之一，一项全球性荟萃分析显示，该方案Hp根除率为78％～89％，但由于其不良反应较多、依从性欠佳，难被人们接受。自克拉霉素应用于根除Hp后．含克拉霉素的铋剂三联或PPI三联1周可明显提高Hp根除率达90％以上，     

影响三联疗法根除幽门螺旋菌的因素

用一种或两种药物治疗HP感染的根治率低于50%,而三联疗法显示根除率>50%,本文评估三联疗法根除HP感染的疗效及其影响因素。材料和方法:十二指肠溃疡70例,胃溃疡17例和胃炎6例,三种抗菌药物为四环素(500mg qid)、灭滴灵(250 mg tid)和次水杨酸铋(每餐时服1或2片,临睡2片,每片150mg)。疗程分为10、14和28天三组。全部病例应用[~(13)C]尿素呼吸试验和ELISA法证实HP状态。82%患者在治疗前活检胃窦粘膜作HP培养、银染色组织学检查,随访是通过内镜活检胃窦粘膜、呼吸试验及血清学检查。根治是指治疗结束后≥1月,无HP存在。结果:93例受试者经4～79周随访(中位数为29周)结果表明总根除率为87%,不同治疗组的根除率为70～100%,无显著性差异,10天、14天和28天的根除率分别为77%、91%和86.6%,其间也无显著性差异。     

State of knowledge of helminth fauna of freshwater fishes of Poland

A total 89 fish and lamprey species has been recorded from Polish freshwater habitats. Twenty-seven of them (30.3%) have not been surveyed for parasitic helminthes. Some of the latter fishes are either rare or not easily accessible. Other live only in specific habitats in scattered localities. An important obstacle for studying parasite faunas of some fishes may be their status on an endangered species. Among the non-surveyed fishes, are those which have been relatively recently introduced to Poland or migrated there on their own. The present paper attempts to review all hitherto not studied helminthologically fish species, their habitats, localities and current protection status.     

高血压降压治疗目标的再认识

根据传统的高血压水平的定义,1993年WHO高血压治疗指南提出血压控制目标为<140/90mm Hg(1mm Hg=0.133kPa),但是并非所有患者都必须将血压降至同一水平,而应根据患者情况进行个体化治疗。Framingham进行的一项长达10～12年的心血管事件研究发现,第5年后,正常上限血压[收缩压(SBP     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.