Clinical Research on Triple Therapy Containing Levofloxacin for First-line Helicobacter Pylori Eradication Treatment_West China Medical Journal

Authors：

TAN Lirang ¹ , LI Hu ¹ , JIN Jun ¹ ,  WU Longfei ²

1. Department of Gastroenterology; 2. Department of Critical Care Medicine, Bazhong Central Hospital, Bazhong, Sichuan 636000, P. R. China;

Corresponding author：

WU Longfei, Email: 1271092104@qq.com

Keywords：

左氧氟沙星; 三联疗法; 幽门螺杆菌

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目的　探讨含左氧氟沙星的三联疗法作为一线方案对幽门螺杆菌感染治疗的有效性和安全性。方法　选择2008年9月－2011年3月125例确诊为幽门螺杆菌感染的初治患者，随机分为雷贝拉唑、阿莫西林联合左氧氟沙星组（A组）和雷贝拉唑、阿莫西林联合克拉霉素组（B组），经治疗7 d后比较两组根除率和不良反应发生率。结果　A、B组幽门螺杆菌符合方案分析根除率分别为91.8%、77.6%，意向性治疗根除率分别为88.9%、72.6%，A组根除率高于B组，差异有统计学意义（P＜0.05）。A、B组不良反应发生率分别为4.8%、3.2%（P＞0.05）。结论　以左氧氟沙星、阿莫西林、雷贝拉唑为组合的三联疗法能显著提高幽门螺杆菌感染的初治成功率，不良反应少，安全有效。

Citation： TAN Lirang,LI Hu,JIN Jun,WU Longfei. Clinical Research on Triple Therapy Containing Levofloxacin for First-line Helicobacter Pylori Eradication Treatment. West China Medical Journal, 2012, 27(3): 329-331. doi: Copy

1.	中华医学会消化病学分会幽门螺杆菌学组. 第三次全国幽门螺杆菌感染若干问题共识报告(2007年8月·庐山)[J]. 中华内科杂志, 2008, 47(4): 346-349.
2.	Lind T, Veldhuyzen van Zanten S, Unge P, et al. Eradication of Helicobacter pylori using one-week triple therapies combining omeprazole with two antimicrobials: the MACH I Study[J]. Helicobacter, 1996, 1(3): 138-144.
3.	成虹, 胡伏莲, 谢勇,等. 中国幽门螺杆菌耐药状况以及耐药对治疗的影响——全国多中心临床研究[J]. 胃肠病学, 2007, 12(9): 525-530.
4.	Saad RJ, Schoenfeld P, Kim HM, et al. Levofloxacin-based triple therapy versus bismuth-based quadruple therapy for persistent Helicobacter pylori infection: a meta-analysis[J]. Am J Gastroenterol, 2006, 101(3): 488-496.
5.	Gisbert JP, Morena F. Systematic review and meta-analysis: levofloxacin-based rescue regimens after Helicobacter pylori treatment failure[J]. Aliment Pharmacol Ther, 2006, 23(1): 35-44.
6.	Malfertheiner P, Megraud F, O’Morain C, et al. Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report[J]. Gut, 2007, 56(6): 772-781.
7.	成虹, 胡伏莲, 李江. 幽门螺杆菌耐药性对其根除治疗影响的研究[J]. 中华医学杂志, 2006, 86(38): 2679-2682.
8.	牟方宏, 胡伏莲杨桂彬,等. 质子泵抑制剂四联疗法作为幽门螺杆菌根除治疗一线方案的临床研究[J]. 胃肠病学, 2007, 12(9): 531-534.
9.	De Francesco V, Margiotta M, Zullo A, et al. Prevalence of primary clarithromycin resistance in Helicobacter pylori strains over a 15 year period in Italy[J]. J Antimicrob Chemother, 2007, 59(4): 783-785.
10.	Mégraud F. H pylori antibiotic resistance: prevalence, importance, and advances in testing[J]. Gut, 2004, 53(9): 1374-1384.
11.	Mégraud F. Update on Therapeutic Options for Helicobacter Pylori-related Diseases[J]. Curr Infect Dis Rep, 2005, 7(2): 115-120.
12.	邹军, 杨昭徐, 覃卓明. 左旋氧氟沙星抗幽门螺杆菌的实验室评价和临床研究[J]. 中华医学杂志, 2003, 83(20): 178-181.
13.	袁媛, 于静, 贾长河. 含左氧氟沙星的一线方案根除幽门螺杆菌疗效分析[J]. 山东医药, 2009, 49(52): 96-97.
14.	Cammarota G, Cianci R, Cannizzaro O, et al. Efficacy of two one-week rabeprazole/levofloxacin-based triple therapies for Helicobacter pylori infection[J]. Aliment Pharmacol Ther, 2000, 14(10): 1339-1343.
15.	Di Caro S, Zocco MA, Cremonini F, et al. Levofloxacin based regimens for the eradication of Helicobacter pylori[J]. Eur J Gastroenterol Hepatol, 2002, 14(12): 1309-1312.
16.	Graham DY, Lu H, Yamaoka Y. A report card to grade Helicobacter pylori therapy[J]. Helicobacter, 2007, 12(4): 275-278.
17.	成虹, 胡伏莲, 张国新, 等. 含左氧氟沙星三联疗法一线治疗幽门螺杆菌感染: 多中心随机对照临床研究[J]. 中华医学杂志, 2010, 90(2): 79-82.
18.	李虎, 谭礼让, 何滨岑, 等. 含铋剂四联疗法作为一线方案根治幽门螺杆菌感染的临床研究[J]. 华西医学, 2011, 26(10): 1488-1490.

1. 　中华医学会消化病学分会幽门螺杆菌学组. 第三次全国幽门螺杆菌感染若干问题共识报告(2007年8月·庐山)[J]. 中华内科杂志, 2008, 47(4): 346-349.
2. 　Lind T, Veldhuyzen van Zanten S, Unge P, et al. Eradication of Helicobacter pylori using one-week triple therapies combining omeprazole with two antimicrobials: the MACH I Study[J]. Helicobacter, 1996, 1(3): 138-144.
3. 　成虹, 胡伏莲, 谢勇,等. 中国幽门螺杆菌耐药状况以及耐药对治疗的影响——全国多中心临床研究[J]. 胃肠病学, 2007, 12(9): 525-530.
4. 　Saad RJ, Schoenfeld P, Kim HM, et al. Levofloxacin-based triple therapy versus bismuth-based quadruple therapy for persistent Helicobacter pylori infection: a meta-analysis[J]. Am J Gastroenterol, 2006, 101(3): 488-496.
5. 　Gisbert JP, Morena F. Systematic review and meta-analysis: levofloxacin-based rescue regimens after Helicobacter pylori treatment failure[J]. Aliment Pharmacol Ther, 2006, 23(1): 35-44.
6. 　Malfertheiner P, Megraud F, O’Morain C, et al. Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report[J]. Gut, 2007, 56(6): 772-781.
7. 　成虹, 胡伏莲, 李江. 幽门螺杆菌耐药性对其根除治疗影响的研究[J]. 中华医学杂志, 2006, 86(38): 2679-2682.
8. 　牟方宏, 胡伏莲杨桂彬,等. 质子泵抑制剂四联疗法作为幽门螺杆菌根除治疗一线方案的临床研究[J]. 胃肠病学, 2007, 12(9): 531-534.
9. 　De Francesco V, Margiotta M, Zullo A, et al. Prevalence of primary clarithromycin resistance in Helicobacter pylori strains over a 15 year period in Italy[J]. J Antimicrob Chemother, 2007, 59(4): 783-785.
10. 　Mégraud F. H pylori antibiotic resistance: prevalence, importance, and advances in testing[J]. Gut, 2004, 53(9): 1374-1384.
11. 　Mégraud F. Update on Therapeutic Options for Helicobacter Pylori-related Diseases[J]. Curr Infect Dis Rep, 2005, 7(2): 115-120.
12. 　邹军, 杨昭徐, 覃卓明. 左旋氧氟沙星抗幽门螺杆菌的实验室评价和临床研究[J]. 中华医学杂志, 2003, 83(20): 178-181.
13. 　袁媛, 于静, 贾长河. 含左氧氟沙星的一线方案根除幽门螺杆菌疗效分析[J]. 山东医药, 2009, 49(52): 96-97.
14. 　Cammarota G, Cianci R, Cannizzaro O, et al. Efficacy of two one-week rabeprazole/levofloxacin-based triple therapies for Helicobacter pylori infection[J]. Aliment Pharmacol Ther, 2000, 14(10): 1339-1343.
15. 　Di Caro S, Zocco MA, Cremonini F, et al. Levofloxacin based regimens for the eradication of Helicobacter pylori[J]. Eur J Gastroenterol Hepatol, 2002, 14(12): 1309-1312.
16. 　Graham DY, Lu H, Yamaoka Y. A report card to grade Helicobacter pylori therapy[J]. Helicobacter, 2007, 12(4): 275-278.
17. 　成虹, 胡伏莲, 张国新, 等. 含左氧氟沙星三联疗法一线治疗幽门螺杆菌感染: 多中心随机对照临床研究[J]. 中华医学杂志, 2010, 90(2): 79-82.
18. 　李虎, 谭礼让, 何滨岑, 等. 含铋剂四联疗法作为一线方案根治幽门螺杆菌感染的临床研究[J]. 华西医学, 2011, 26(10): 1488-1490.

West China Medical Journal

Clinical Research on Triple Therapy Containing Levofloxacin for First-line Helicobacter Pylori Eradication Treatment

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