中国实用儿科杂志

中国实用儿科杂志

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儿童幽门螺杆菌感染根除治疗疗效分析

  

  1. 浙江大学医学院附属儿童医院消化科，浙江  杭州 310003
  • 出版日期:2018-04-06 发布日期:2018-04-16

Efficiency of eradication therapy for Helicobacter pylori infection in children

  1. Department of Gastroenterology，Children’s Hospital，Zhejiang University School of Medicine，Hangzhou  310003，China
  • Online:2018-04-06 Published:2018-04-16

摘要：

目的    了解儿童幽门螺杆菌（Hp）感染的临床根除治疗情况并分析原因。方法　以2012年1月至2015年10月浙江大学医学院附属儿童医院消化专科门诊的301例Hp感染患儿为研究对象， 判断Hp根除治疗后的临床根除率。 结果　初始治疗中OAC方案（奥美拉唑+阿莫西林+克拉霉素）根除率42.3%， 非OAC方案根除率56.7%， 两者间差异有统计学意义（P＜0.05）；含铋剂疗法根除率50.0%， 标准三联疗法根除率41.2%， 两者间差异无统计学意义（P＞0.05）。补救治疗中铋剂四联疗法根除率58.3%， 呋喃唑酮三联疗法根除率55.0%， 两者间差异无统计学意义（P＞0.05）。119株Hp对阿莫西林不耐药， 对克拉霉素和甲硝唑耐药率分别是27.7%和63.9%。结论　儿童Hp感染的临床根除率未能达到目标根除率80%，药敏试验为基础的治疗仍是儿童Hp感染根除治疗的首选。

关键词: 儿童, 幽门螺杆菌, 根除率, 耐药率, 药敏试验

Abstract:

Objective　To understand the clinical eradication therapy for Helicobacter pylori infection in children and analyze the causes. Methods　H.pylori eradication therapy for 10 or 14 days was accepted by 301 cases of children，who were diagnosed with H.pyori infection，in the Children’s Hospital of Zhejiang University School of Medicine from January，2012 to October，2015.  Finally，the eradication rate of H.pylori was judged. Results　In initial treatment，the eradication rate of OAC program（omeprazole，amoxicillin and clarithromycin） was 42.3%，the eradication rate of non-OAC program was 56.7%，and there were statistically significant differences between the two groups（P＜0.05）. The eradication rate of bismuth-based regimens was 50.0%，the eradication rate of standard triple therapy was 41.2%，and there were no statistically significant differences between the two groups（P＞0.05）. In the rescue treatment，the eradication rate of bismuth-based quadruple therapy was 58.3%，the eradication rate of triple therapy with furaxone was 55.0%，and there were no statistically significant differences between the two groups（P＞0.05）. Totally 119 strains of H.pylori were not resistant to amoxicillin，while the resistance rate to clarithromycin and metronidazole was 27.7% and 69.3%，respectively. Conclusion　In this study，the clinical eradication rate in children with Hp infection fails to achieve the goal eradication rate of 80%. Drug sensitivity test is still the first choice for treatment of Helicobacter pylori infection in children.

Key words: child, Helicobacter pylori, eradication rate, resistance rate, drug sensitivity test