含左氧氟沙星三联疗法治疗幽门螺杆菌阳性残胃炎的疗效观察［摘要］目的评价含左氧氟沙星三联疗法治疗幽门螺杆菌(Helicobacterpylori,Hp)阳性残胃炎患者的疗效。方法将35例Hp阳性的残胃炎患者随机分为两组，治疗纟fl给予埃索美拉哇20mg/次，阿莫西林1000mg/次，左氧氟沙星200mg/次，均为2次/d,连服7d。对照组给予埃索美拉哇20mg/次，阿莫西林1000吨/次，甲硝哇400mg/次，均为2次/d,连服7cL治疗前及停药4周后观察临床症状改善情况、lip清除率，并通过胃镜检查比较残胃黏膜炎症变化。结果治疗组治疗示总有效率为88.89%,较对照组(64.71%)显著提高；Hp清除率治疗纟fl为94.44%,对照纟R为70.59%,差异有统计学意义(P<0.05)；且两纟R症状积分、残胃黏膜炎症活动度差异均有统计学意义(均P<0.05).结论含左氧氟沙星三联疗法对Hp阳性残胃炎患者Hp根除效果明显好于标准三联疗法，Hp根除麻临床症状可显著改善。［关键词］残胃炎；左氧氟沙星；幽门螺杆菌［中图分类号］R573.1［文献标识码］A［文章编号］1673-7210(2012)01(b)-084-03EfficacyofLevofloxacin-basedtripletherapyinpatientswithremnantgastritisofHelicobacterpyloriinfectionLIUYanHUHongsongLIXuefengCHENXiaohongHUANGSuxianHUANGMiaojuanYUHonghuaDepartmentofGastroenterology,thePeople'sHospitalofLonggangDistrictinShenzhenCity,GuangdongProvince,Shenzhen518172,China［Abstract］ObjectiveToobservethetherapeuticeffectsofLevof1oxacin-basedtripletherapyinpatientswithremnantgastritsofHelicobacterpylori(Hp)infection.Methods35pationtswithremriantgastritsofHpinfectionwererandomlydividedinto2groups.18casesoftreatedgroupweretakenEsomeprazole20mgbicl,Amoxicillin1000mgbid,Levofloxacin200mgbid,for7clays;17casesofcontrolgroupweretakenEsomeprazole20mgbid,Amoxicillin1000mgbid,Metronidazole400mgbid,for7days・ThemendmattersofclinicalsymptomsandHperadicationratesbeforetreatmentandaftertreatmcntfor4weekswerecomparedbetweenthetwogroups,andtheinflammationchangesofgastricremnantmucousmembranewerecomparedthroughgastroscope.ResultsThetotaleffectiverateoftreatmentgroupwas88・89%,significantlyhigherthanthecontrolgroup(84.71%),theUperaclicationratewas94.44%inthetreatmentgroupand70・59%inthecontrolgroup,andthereweresignifiedntdifferencesbetweenthetwogroups(P<0・05)・Thedifferencesofsymptomscoresandtheinflemmationmobilityofgastricremnantmucousmembranebetweenthetwogroupsweresignificant(P<0.05).ConclusionTheLevofloxacin-basedtripletherapyhasabettereffectforremnantgastritspatientsinHperaclicationthanstandardtripletherapyandthesymptomscanbesignificantlyimprovedafterHperaclication.［Keywords］Remnantgastrits;Levofloxacin;Helicobacterpylori残胃炎是胃次全切除术示最常见的一种疾病。一般发生在术示几个月至几年。根据国内外文献报道，胃部分切除术后冇60%〜100%患者发生残胃炎［1］。其临床表现主要为腹痛、腹胀、烧心、呕吐胆汁，内镜下多表现为近吻合口区充血、水肿和出血倾向，其主要发生原因为幽门螺杆菌(Helicobacterpylori,Hp)感染和十二指肠液反流。残胃是胃的癌前期状态2—，Hp感染除了肓接导致残胃炎外，其在胃癌发生中的作用不可忽视［2］。目前采用传统经典抗Hp方案疗效有所下降，故Hp阳性残胃炎应该采取更有效的根除Hp方案。木研究旨在评价含左氧氟沙星三联疗法与标准三联疗法根除Hp的效果，并口随访根除Hp后残胃炎临床疗效，为后续临床应用奠定基础。1资料与方法1.1一般资料从我院2006年3月〜2010年7月病例中筛选35例经胃镜及14C-尿素呼气试验(14C-UBT)证实为Hp阳性残胃炎的患者进入木次研究。35例患者均为胃大部切除术后，胃大部切除术后时间为4个月〜15年。胃次全切除原因：消化性溃疡12例，反复上消化道出血8例，胃窦部肿瘤7例，胃穿孔5例，幽门梗阻3例。都有不同程度的腹胀、腹痛、烧心、呕吐胆汁,并排除全身其他系统...