在儿童中消除Helicobacter pylori感染的不同方案:一项随机对照试验
Sana Hosny Barakat1, Hind M Hanafy1, Maha Guimei2
1Pediatric Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
European journal of pediatrics
|November 15, 2024
概括
基于西普罗素的三重疗法 (CTT) 是最有效的治疗方法,可以消除儿童的Helicobacter pylori感染,成功率为90%. 其他疗法,如三重疗法 (TT) 的疗效较低,突出显示CTT是安全和卓越的经验选择.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 传染性疾病 传染性疾病
- 微生物学 微生物学
背景情况:
- 在儿童中消除Helicobacter pylori (H. pylori) 由于抗生素耐药性和治疗效率降低,尤其是在发展中国家,越来越困难.
- 对于儿科H. pylori感染的标准三重疗法 (TT) 疗效已经下降,需要评估替代的经验治疗方案.
- 这项研究解决了儿童群体中H. pylori根除的挑战,在儿童群体中,治疗选择有限,耐药性是一个日益关注的问题.
研究的目的:
- 为了比较五种实证H. pylori根除治疗在儿童中的疗效和安全性:三重疗法 (TT),序列疗法 (ST),混合疗法 (HT),并发疗法 (CT) 和基于西普罗夫洛克萨的三重疗法 (CTT).
- 确定最有效的实证治疗方案,以消除小儿患者的H. pylori.
- 评估不同H. pylori根除方案在儿童中的安全性.
主要方法:
- 一项随机对照试验,涉及200名年龄在3至16岁的儿童,确诊感染H. pylori (快速尿素酶试验和组织病理学).
- 患者被随机分配,接受五种疗法之一:TT,ST,HT,CT或CTT.
- 通过ELISA通过便抗原测试 (SAT) 确认了抗生素后4周和PPI后2周的消灭.
主要成果:
- 基于西普洛素的三重疗法 (CTT) 实现了最高的根除率90%,明显高于三重疗法 (TT) (70%,p=0.025).
- 其他疗法的根除率为:ST 77.5%,HT 80%,CT 85%.
- 在治疗组中,不良反应的发生率没有显著差异,这表明可比的安全性.
结论:
- 基于西普罗素的三重疗法 (CTT) 是对儿童的H. pylori根除的安全和高度有效的实证治疗方法.
- 序列疗法 (ST),混合疗法 (HT) 和并发疗法 (CT) 与标准三重疗法 (TT) 相比没有显示出更高的疗效.
- 在儿童H. pylori感染中,CTT成为一个有前途的治疗选择,比传统方法提供更好的根除率.
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