【摘要】 目的观察含莫西沙星三联疗法和含左氧氟沙星三联疗法治疗初治失败的幽门螺杆菌(Hp)感染的临床疗效和不良反应,并比较它们的根除率。方法将132例经标准三联疗法治疗失败的Hp感染患者随机分为A组和B组,二组均为66例。A组给予口服莫西沙星(400mg/次,1次/d)+阿莫西林(1g/次,2次/d)+泮托拉唑(40mg/次,2次/d);B组给口服予左氧氟沙星(500mg/次,1次/d)+阿莫西林(1g/次,2次/d)+泮托拉唑(40mg/次,2次/d)。两组均治疗10d,停服质子泵及抗生素4周后行14C-BUT或者13C-BUT试验检测Hp感染是否根治。结果按意向治疗分析(ITT)A组和B组的Hp根除率分别为83.33%和68.18%,有显著性差异(P=0.042);按符合方案分析(PP)A组和B组的Hp根除率分别为88.71%和72.58%,有显著性差异(P=0.023)。两组的不良反应率分别为9.1%和10.6%,无显著差异(P=0.770)。结论含莫西沙星的三联疗法治疗初治失败的Hp感染优于含左氧氟沙星的三联疗法,是一种安全而有效的Hp根除二线方案。更多还原

【Abstract】 Objective To compare the efficacy and adverse-effect of Moxifloxacin-based triple therapy and Levofloxacin-based triple therapy as second-line treatment for Helicobacter pylori infection. Methods One hundred and thirty-two patients with failed first-line HP eradication treatment were randomly divided into 2 groups: groups A( n = 66) orally received moxifloxacin 400mg qd + pantoprazole 40mg bid + amoxicillin 1. 0g bid; group B( n = 66) orally received Levofloxacin 500mg + pantoprazole 40mg bid + amoxillin 1. 0g bid. The patients in both groups were treated for 10 days. The eradication rates of Hp were evaluated by13C-urea breath test or14C-urea breath test 4 weeks after the treatment. Results The rates of Hp eradication in groups A and B were 83. 33% and 68. 18% by intention-to-treat analysis,there was significant difference( P = 0. 042). The rates of Hp eradication in groups A and B were 88. 71% and 72. 58% by per-protocol analysis,there was significant difference( P = 0. 023). The rates of adverse-effect of the two groups were 9. 1% and 10. 6%. There was no significant difference( P = 0. 770). Conclusion Moxifloxacin-based triple therapy is superior to Levofloxacin-based triple therapy as secondline treatment for helicobacter pylori infection. It is an effective and safe choice.更多还原