左氧氟沙星初治慢性胃炎并Hp阳性的临床疗效及胃黏膜左氧氟沙星浓度与Hp根除的关系

目的探讨左氧氟沙星治疗慢性胃炎并幽门螺杆菌感染患者的有效方案,并分析影响Hp根除率的相关因素。方法选择确诊为左氧氟沙星方案初次治疗慢性胃炎并Hp阳性患者164例为研究对象,随机分为7 d方案组（85例）和10 d方案组（79例）,7 d方案组采用左氧氟沙星三联方案治疗,疗程7 d,10 d方案组疗程10 d,比较两组患者的临床症状缓解率、Hp根治率、胃黏膜左氧氟沙星浓度,并分析其他可能影响左氧氟沙星根治方案Hp根除率的相关因素。结果 7 d方案组和10 d方案组Hp根除率以及症状缓解率没有显著差异（P〉0.05）。患者疗程结束后4～8周14C尿素呼气实验结果 ,131例Hp根除成功,33例Hp根除失败。不同方案患者胃黏膜左氧氟沙星浓度比较差异无统计学意义（P〉0.05）。成功者胃黏膜左氧氟沙星浓度显著高于根除失败者（P〈0.01）。结论左氧氟沙星方案初治慢性胃炎并Hp阳性患者7 d疗程方案与10 d疗程方案Hp根除率相似,且延长治疗时间并不能显著增加患者胃黏膜左氧氟沙星浓度,而患者胃黏膜左氧氟沙星浓度与Hp的根除率密切相关。

Clinical efficacy of levofloxacin program in initial treatment of chronic gastritis patients with positive Hp and relationship of mucosal concentrations of levofloxacin with Hp eradication

Objective To discuss clinical efficacy of Levofloxacin program in initial treatment of chronic gastritis patients with positive Hp. Methods Selected 164 cases with chronic gastritis patients with positive Hp were randomly divided into 7 d group（85 cases） and 10 d group（79 cases）. 7d group was treated by Levofloxacin program for 7 d, and10 d group was treated by Levofloxacin program for 10 d. Clinical efficacy, Hp eradication rate, and mucosal concentrations of levofloxacin were compared, and influencing factors of Hp eradication rate was analyzed. Results Hp eradication rate and remission rate of two groups showed no significant difference（P〉0.05）.^14C-urea breath test results after4-8 weeks of treatment showed 131 cases with success of Hp eradication, 33 cases with fail of Hp eradication. Mucosal concentrations of levofloxacin of two groups showed no significant difference（P〉0.05）. Mucosal concentrations of levofloxacin of cases with success of Hp eradication were significant higher than cases with fail of Hp eradication（P〈0.01）. Conclusion Levofloxacin program in initial treatment of chronic gastritis patients with positive Hp, Hp eradication rates of 7 d program and 10 d program show no significant difference, and to extend the treatment time can not significantly increase the mucosal concentrations of levofloxacin, and mucosal concentrations of levofloxacin was correlation with Hp eradication rate.