基于Helicobacter pylori根除抗生素耐药性概况的同时治疗与量身定制治疗:系统性审查和元分析
Ayan Khalid1, Sabula Tabish1, Muhammad Burhan1
1Department of Medicine Dow University of Health Sciences Karachi Pakistan.
JGH open : an open access journal of gastroenterology and hepatology
|December 12, 2025
概括
以抗生素敏感性测试为指导的量身定制治疗提供了比标准并发治疗更高的Helicobacter pylori根除率和更少的副作用. 建议采用这种方法,尤其是在抗生素耐药性较高的地方.
科学领域:
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
- 临床试验和元分析
背景情况:
- 抗生素耐药性的增加使得 Helicobacter pylori (H. pylori) 的根除更加复杂.
- 同时治疗的有效性在耐药性设置下降.
- 以抗菌素敏感性测试 (AST) 为指导的量身定制治疗可以改善H. pylori根除结果.
研究的目的:
- 为了比较量身定制治疗的疗效和安全性与第一线H. pylori根除的同时治疗.
- 通过治疗意图 (ITT) 和每协议 (PP) 分析来分析根除率.
- 评估与每个治疗策略相关的不良事件的发生率.
主要方法:
- 八项随机对照试验 (RCT) 的元分析,涉及2524名以前没有接受过治疗的成年人.
- 通过2025年4月搜索主要数据库 (PubMed,谷歌学者,Cochrane,临床试验.gov)
- 主要结局:H. pylori根除率 (ITT和PP);次要结局:不良事件.
主要成果:
- 量身定制的治疗显示出更高的根除率:87.4% (ITT) 与83.2% (同时使用) 和92.6% (PP) 与89.1% (同时使用).
- 量身定制的治疗与明显较少的不良事件 (35.6%与45.6%) 相关.
- 对于根除率 (p<0.05) 和不良事件 (p=0.0007) 实现的统计学意义.
结论:
- 量身定制的治疗提供优越的H. pylori根除率与实证并发治疗相比.
- 量身定制的治疗与明显较低的不良事件发生率有关.
- 应优先选择量身定制的疗法作为一线治疗,特别是在高耐药性区域和扩大快速测试访问的地区.
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