泮托拉唑与根除幽门螺杆菌治疗对服用阿司匹林老年患者胃及十二指肠损伤的预防作用

发布时间：2018-06-06 10:19

本文选题：泮托拉唑 + 幽门螺杆菌　；参考：《中国老年学杂志》2015年08期

【摘要】：目的探讨泮托拉唑维持治疗1个月与单纯根除幽门螺杆菌(Hp)治疗10 d对服用阿司匹林老年患者胃及十二指肠损伤的预防作用。方法 116例年龄超过60岁、既往未行根除Hp治疗、因心脑血管病预防及治疗需要服用阿司匹林至少3个月的老年患者,无论有无消化不良症状或消化性溃疡病史均行胃镜检查及Hp感染检测,其中证实为Hp阳性、除外严重胃及十二指肠损伤黏膜损伤、否认青霉素过敏的患者随机分为两组:泮托拉唑维持治疗组(泮托拉唑40 mg,2次/d,疗程1个月)和根除Hp组(泮托拉唑40 mg,2次/d;阿莫西林1.0 g,2次/d;呋喃唑酮0.1 g,2次/d;果胶铋0.2 g,2次/d,疗程10 d)。所有患者同时服用阿司匹林100 mg,1次/d。1个月后再次行胃镜检查和Hp检测。结果 116例患者中有21例患者Hp阴性,8例有严重的胃及十二指肠黏膜损伤。共87例患者纳入实验分组,其中根除Hp组43例,泮托拉唑维持治疗组44例。治疗结束后,根除Hp组有4例患者仍为Hp检测阳性,泮托拉唑维持治疗组也有19例患者13C呼气试验和快速尿素酶试验阴性。根除Hp组有9例患者发生严重胃及十二指肠黏膜损伤,泮托拉唑维持治疗组无患者发生。根除Hp组与泮托拉唑维持治疗组发生恶化的比率分别为48.84%和25%(P0.05),病情改善的比率分别为9.3%和15.91%(P0.05),无变化率分别为41.86%和59.09%。结论对于需要长期服用阿司匹林的老年患者,无论是否合并Hp感染,采用1个月的泮托拉唑抑酸治疗较短期单纯根除Hp治疗更能有效预防非甾体类消炎药物引起的胃及十二指肠黏膜损伤,长期抑酸治疗可能较Hp检测并进行单纯的根除治疗更有临床价值。
[Abstract]:Objective to investigate the preventive effect of pantoprazole in the treatment of 1 months and simple eradication of Helicobacter pylori (Hp) in the treatment of gastric and duodenal injury in elderly patients taking aspirin. Methods 116 cases of elderly patients over the age of 60 years old, without previous eradication of Hp, were treated with aspirin for at least 3 months for the prevention and treatment of cardiovascular and cerebrovascular diseases. Patients, regardless of the symptoms of indigestion or peptic ulcer, were examined by gastroscopy and Hp infection, which proved to be Hp positive except for severe gastric and duodenal injury. The patients who denied penicillin allergy were randomly divided into two groups: pantoprazole maintenance treatment group (pantoprazole 40 mg, 2 /d, 1 months of treatment) and Hp eradication Group (pantoprazole 40 mg, 2 /d; amoxicillin 1 g, 2 /d; furazolidone 0.1 g, 2 /d; pectin bismuth 0.2 g, 2 /d, 10 d). All patients took aspirin 100 mg, repeated gastroscopy and Hp test after /d.1 month 1. A total of 87 patients were included in the experimental group, among which 43 cases were eradicated in group Hp and 44 cases of pantoprazole maintenance treatment group. After treatment, 4 patients in group Hp were still positive for Hp, and 19 patients in pantoprazole maintenance group were also negative for 13C breath test and rapid urease test. There were 9 patients with severe gastric and duodenal adhesion in group Hp. The rate of deterioration in the group Hp and pantoprazole maintenance treatment group was 48.84% and 25% (P0.05), the rate of improvement was 9.3% and 15.91% respectively (P0.05), and the rate of no change was 41.86% and 59.09%., respectively, to the elderly patients who took aspirin for a long time, respectively. There is no combination of Hp infection. The 1 months pantoprazole anti acid treatment is more effective in preventing gastric and duodenal mucosal injury caused by non steroidal anti-inflammatory drugs. The long-term acid suppression therapy may be more clinical value than Hp detection and simple eradication therapy.
【作者单位】：吉林大学中日联谊医院门诊部办公室;吉林大学中日联谊医院消化内科;吉林大学中日联谊医院神经内一科;
【分类号】：R57

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