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。

Short Term and Long Term Effect of Ranitidine Triple Therapy on Helicobac-ter Pylori Positive Duodenal Ulcer

We have treated 82 cases of helicobacter pylori (HP) positive duodenal ulcer with triple therapy of ranitidine, amoxicillin and metronidazole for 2 weeks and followed up 1 year to investigate the short term and long term effect. 145 cases treated with bismuth triple therapy were used as control. The results showed that the rate of ulcer healing was 87.8% and HP eradication, 89.0% in treatment arm versus 92.4% and 85.7% respectively in control arm (P>0.05). However the rate of adverse reactions was significantly lower in the treatment arm (7.3%) than that in control (21.4%) (P<0.05). In the follow-up study in treatment arm, HP recrudescence was found in 9 cases (12.3%) and reinfection, in 2 cases (2.7%). Ulcer relapse rate was 1/61 (1.6%) in HP negative group versus 7/11 (63.6% ) in positive group (P<0.01), As the recrudescense rate was high and all occured between 4-8 weeks after the ceasation of treatment. We suggested that the standard time for evaluating HP eradication should set on the end of 8 weeks instead of the 4 weeks generally used now.