摘要
目的探讨阿莫西林联合不同铋剂四联方案治疗海原地区幽门螺杆菌(Hp)感染患者的效果,分析该方案对患者Hp根除率及不良反应的影响。方法选取2023年2月-10月宁夏回族自治区人民医院收治的75例海原地区Hp感染患者作为研究对象,按照治疗方案不同分为米诺环素组(44例)和左氧氟沙星组(31例)。两组均给予阿莫西林+艾司奥美拉唑+果胶铋基础治疗,米诺环素组在此基础上加用米诺环素治疗,左氧氟沙星组加用左氧氟沙星治疗。比较两组临床疗效及Hp根除率、免疫功能指标(CD4^(+)、CD4^(+)/CD8^(+)、CD8^(+))、炎性因子水平[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]及不良反应发生率。结果米诺环素组总有效率(93.18%)、Hp根除率(90.91%)均高于左氧氟沙星组(80.65%、74.19%)(P<0.05)。治疗后,两组CD4^(+)、CD4^(+)/CD8^(+)均较治疗前升高,CD8^(+)较治疗前降低,且米诺环素组CD4^(+)、CD4^(+)/CD8^(+)高于左氧氟沙星组,CD8^(+)低于左氧氟沙星组(P<0.05)。治疗后,两组IL-6、TNF-α、CRP均较治疗前降低,且米诺环素组IL-6、TNF-α、CRP低于左氧氟沙星组(P<0.05)。米诺环素组不良反应发生率(9.09%)低于左氧氟沙星组(22.58%),但差异无统计学意义(χ^(2)=3.128,P=0.077)。结论阿莫西林联合艾司奥美拉唑+果胶铋+米诺环素四联方案治疗海原地区Hp感染患者的Hp根除率更高,能改善患者免疫功能,减轻炎症反应,且安全性良好,更适合作为该地区的治疗方案。
Objective To investigate the effect of amoxicillin combined with different bismuth quadruple regimens in the treatment of patients with Helicobacter pylori(Hp)infection in Haiyuan area,and to analyze the effect of this regimen on Hp eradication rate and adverse reactions.Methods A total of 75 patients with Hp infection in Haiyuan area admitted to People′s Hospital of Ningxia Hui Autonomous Region from February to October 2023 were selected as the research objects.According to different treatment schemes,they were divided into minocycline group(44 patients)and levofloxacin group(31 patients).Both groups were given amoxicillin+esomeprazole magnesium+bismuth pectin basic treatment.The minocycline group was treated with minocycline on this basis,and the levofloxacin group was treated with levofloxacin.The clinical efficacy,Hp eradication rate,immune function indexes(CD4^(+),CD4^(+)/CD8^(+),CD8^(+)),inflammatory factor levels[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)]and incidence of adverse reactions were compared between the two groups.Results The total effective rate(93.18%)and Hp eradication rate(90.91%)of minocycline group were higher than those of levofloxacin group(80.65%,74.19%)(P<0.05).After treatment,CD4^(+)and CD4^(+)/CD8^(+)in the two groups were higher than those before treatment,CD8^(+)was lower than that before treatment,and CD4^(+)and CD4^(+)/CD8^(+)in the minocycline group were higher than those in the levofloxacin group,CD8^(+)was lower than that in the levofloxacin group(P<0.05).After treatment,IL-6,TNF-αand CRP in the two groups were lower than those before treatment,and IL-6,TNF-αand CRP in the minocycline group were lower than those in the levofloxacin group(P<0.05).The incidence of adverse reactions in minocycline group(9.09%)was lower than that in levofloxacin group(22.58%),but the difference was not statistically significant(χ^(2)=3.128,P=0.077).Conclusion Amoxicillin combined with esomeprazole magnesium+bismuthpectin+minocycline quadruple regimen has a higher eradication rate of Hp in patients with Hp infection in Haiyuan area.Meanwhile,it can improve the immune function of patients,reduce the inflammatory response,and has good safety.It is more suitable as a treatment plan in this area.
作者
马林科
马守成
MA Linke;MA Shoucheng(Department of Gastroenterology,People′s Hospital of Ningxia Hui Autonomous Region/People′s Hospital of Autonomous Region Affiliated to Ningxia Medical University,Yinchuan 750002,Ningxia,China)
出处
《医学信息》
2025年第24期132-136,共5页
Journal of Medical Information
关键词
阿莫西林
铋剂
四联方案
幽门螺杆菌
免疫功能
炎性因子
海原地区
Amoxicillin
Bismuth
Quadruple scheme
Helicobacter pylori
Immune function
Inflammatory factors
Haiyuan area
