【摘要】 目的 探讨含铋剂四联疗法对幽门螺杆菌(Hp)阳性慢性胃炎患儿的治疗效果。方法 回顾性分析2021年4月—2024年2月温州医科大学苍南医院收治的105例Hp阳性慢性胃炎患儿临床资料，根据治疗方法分为两组。对照组50例予以奥美拉唑、阿莫西林、克拉霉素的传统三联疗法，观察组55例予以奥美拉唑、阿莫西林、克拉霉素联合枸橼酸铋钾的含铋剂四联疗法，两组均治疗14 d。比较两组临床疗效、Hp根除率，比较治疗前后两组血清胃肠激素指标[生长抑素(SS)、胃泌素(GAS)、胃动素(MTL)、胆囊收缩素(CCK)]和炎症因子[TNF-α、IL-23、超敏C反应蛋白(hsCRP)]水平，并观察不良反应及复发情况。结果 与对照组比较，观察组总有效率和Hp根除率较高(P<0.05),治疗14 d后血清GAS、MTL、CCK、TNF-α、IL-23、hsCRP水平降低(P<0.05),血清SS水平升高(P<0.05)。治疗期间，两组均未见严重不良反应发生。对Hp根除成功的患儿随访6个月，观察组复发率为4.00%,低于对照组的20.00%(P<0.05)。结论 含铋剂四联疗法用于Hp阳性慢性胃炎患儿的临床效果较好，能够调节胃肠激素与炎症因子水平，降低复发风险，且安全性良好。更多还原

【Abstract】 Objective To explore the therapeutic effect of bismuth-containing quadruple therapy in children with Helicobacter pylori(Hp)-positive chronic gastritis.Methods A retrospective analysis was conducted on the clinical data of 105 children with Hp-positive chronic gastritis admitted to Cangnan Hospital of Wenzhou Medical University from April 2021 to February 2024.The patients were divided into two groups according to the treatment regimens.The control group(50 cases) received the traditional triple therapy of omeprazole, amoxicillin and clarithromycin, while the observation group(55 cases) received the bismuth-containing quadruple therapy of omeprazole, amoxicillin, clarithromycin combined with bismuth potassium citrate.Both groups were treated for 14 days.The clinical efficacy and Hp eradication rate were compared between the two groups.The levels of serum gastrointestinal hormones [somatostatin(SS),gastrin(GAS),motilin(MTL) and cholecystokinin(CCK)] and inflammatory factors [TNF-α,IL-23 and high-sensitivity C-reactive protein(hs-CRP)] were compared between the two groups before and after treatment.Adverse reactions and recurrence were also observed.Results Compared with the control group, the observation group had higher total effective rate and Hp eradication rate(P<0.05).After 14 days of treatment, the levels of serum GAS,MTL,CCK,TNF-α,IL-23 and hs-CRP were decreased(P<0.05),while the level of serum SS was increased in the observation group(P<0.05).No serious adverse reactions occurred in either group during treatment.A 6-month follow-up of children with Hp eradication showed that the recurrence rate of the observation group was 4.00%,which was lower than 20.00% of the control group(P<0.05).Conclusion Bismuth-containing quadruple therapy has high efficacy in the treatment of children with Hp-positive chronic gastritis.It can regulate the levels of gastrointestinal hormones and inflammatory factors, reduce the risk of recurrence, and has good safety.更多还原