在患有功能衰退的患者中进行除疗法:系统性审查
Toshihiro Nishizawa1,2, Masaya Sano2,3, Osamu Toyoshima2
1Department of Gastroenterology and Hepatology, International University of Health and Welfare, Narita Hospital, Narita 286-8520, Japan.
Journal of clinical medicine
|February 10, 2024
概括
对于患有功能障碍的患者,建议采用Helicobacter pylori (H. pylori) 根除方案,使用质子抑制剂 (PPI),克拉里思罗米辛和美特罗尼达. 这种组合显示出更好的根除率和较少的脏不良事件与阿莫西西林治疗相比.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
背景情况:
- 人们对Helicobacter pylori根除疗法对功能影响存在担忧.
- 进行了对文献的系统审查,以评估H. pylori在这个人群中根除的安全性和有效性.
研究的目的:
- 系统地审查有关功能障碍患者的Helicobacter pylori根除现有文献.
- 在功能受损的患者中评估不同根除方案的安全性和有效性.
主要方法:
- 使用PubMed,Cochrane图书馆和Igaku Chuo Zasshi进行了系统的文献搜索.
- 包括对患有功能障碍的患者的H. pylori根除的比较研究.
主要成果:
- 一项随机试验表明,PPI + 克拉里素 + 甲尼达导致急性功能衰竭发生率显著降低 (2%) 与PPI + 克拉里素 + 氨基 (18%) 相比.
- 与阿莫西西林治疗方案 (76.3%) 相比,甲尼达治疗方案也显示出更高的根除率 (92.5%).
- 四份报告显示,在患有或没有功能障碍的患者中,PPI + 澄素 + 氨基素的消除率和不良反应相似,建议剂量调整为肌素清除率≤30毫升/分钟.
结论:
- 质子抑制剂 (PPI),克拉里素和美特罗尼达的组合是H. pylori根除功能障碍患者的推方案.
- 根据功能调整的抗生素剂量,PPI,清素和阿莫西西林是可行的替代治疗选择.
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