儿童幽门螺杆菌感染的临床治疗分析

目的 探讨序贯疗法以及两种三联疗法治疗儿童幽门螺杆菌(Hp)感染的临床疗效,寻找一种根除率高、不良反应少,更经济的幽门螺杆菌根除方法.方法 选择经Hp相关检查均符合Hp感染诊断标准的患儿129例,随机分为A组:10 d序贯疗法44例,B组:7 d三联疗法组43例和C组:14 d三联疗法组42例；A组前5d应用奥美拉唑+阿莫西林/克拉维酸钾,每日早晚2次口服;后5d应用奥美拉唑+克拉霉素+甲硝唑,每日早晚2次口服；B组予阿莫西林/克拉维酸、克拉霉素和奥美拉唑,每日早晚2次口服,疗程1周；C组予阿莫西林、克拉霉素和奥美拉唑,每日早晚2次口服,疗程2周.结果 A、B、C组Hp根除率分别为86.5％、79.1％和64.3％,A组与B组Hp根除率差异无统计学意义,A组与C组Hp根除率差异有统计学意义(P＜0.05)；临床疗效比较差异无统计学意义;A组不良反应发生率与B组比较差异无统计学意义,与C组比较差异有统计学意义(P＜0.05).结论 10d序贯疗法和阿莫西林/克拉维酸、克拉霉素和奥美拉唑疗程1周的三联疗法,是治疗儿童HP感染简单、经济、有效的治疗方法,且前者不良反应更少,依从性更好.

Clinical tveatment of Helicobacter pyloriinfection in children

OBJECTIVE To compare the clinical effects of 10-day sequential therapy and 7days and 14 days triple therapy for the eradication of children′s Helicobacter pylori infection,so as to find out the best Hp eradication program with higher eradication rate,better compliance and more economical.METHODS A total of 129 children with Hp infection confirmed by Hp related inspection were randomly divided into three groups.10-day sequential therapy group(A group)received omeprazole plus amoxicillin-clavulanate for the first five days,and omeprazole,clarithromycin and metronidazole in the remaining five days.Group B was given amoxicillin-clavulantic acid,clarithromycin and omeprazole for one week while the group C was given the same dosages of amoxicillin,clarithromycin and omeprazole for two weeks.All drugs were given twice daily.RESULTS Hp eradication rate was 86.5% in group A,79.1% in group B and 64.3% in group C.There was no significant difference of Hp eradication rate between the group A and group B(P>0.05),while significant difference was observed between group A and group C(P<0.05).There was no significant difference among the three groups about the clinical curative effect(P>0.05).There were no significant difference in the incidence rate of adverse reactions between group A and group B(P>0.05),while significant difference was found between group A and group C(P<0.05).CONCLUSION 10-day sequential therapy and the triple therapy composed of amoxicillin-clavulantic acid,clarithromycin and omeprazole for one week were simple and effective in eradicating Hp infection in children,and the former treatment had fewer adverse events and better compliance.