摘要
目的比较不同治疗方案对慢性阻塞性肺病（COPD）患者Hp感染的根除率，探讨成功根除Hp对COPD患者临床特征的影响。方法选取2006年12月至2009年12月吉林大学中日联谊医院Hp感染的稳定期COPD患者89例并分为根除组和不根除组，其中根除组又分为克拉霉素组和莫西沙星组。三组皆接受常规COPD治疗。克拉霉素组联用埃索美拉唑、阿莫西林、克拉霉素、胶体次枸橼酸铋。莫西沙星组联用埃索美拉唑、阿莫西林、胶体次枸橼酸铋、莫西沙星。患者分别在入组时及随访12个月时接受肺功能检测、运动耐力评价、呼吸困难评分、健康相关生活质量评分，并统计1年内COPD急性发作的次数。统计学处理采用X^2检验和t检验。结果克拉霉素组Hp根除率[48．4％（15／31）]低于莫西沙星组[87．1％（27／31）]，差异有统计学意义（X^2=4．22，P=0．032）。27例不根除组患者第1秒用力呼气容积占预计值百分比的下降程度与53例成功根除Hp者比较差异无统计学意义（t=0．677，P=0．265）。入组时与随访12个月时比较，53例成功根除Hp者6min步行距离、Borg呼吸困难评分、圣乔治呼吸问题调查问卷总评分均获有统计学意义的改善（t=1．884、1．877、1．773，P=0．032、0．025、0．034），27例不根除组患者则皆未获改善。53例成功根除Hp者1年内平均COPD急性发作次数（1．2次）与不根除组（1．90：）比较差异有统计学意义（t=1．812，P=0．034）。结论COPD患者接受含莫西沙星的Hp根除方案或可获较高的Hp根除率。Hp感染的COPD患者根除Hp可在一定程度上提高运动耐力，减轻呼吸困难，提高生活质量，减少急性发作次数。
Objective To compare the Helicobacter pylori （Hp） eradication rate of different therapies and to explore the effects of Hp eradication on the clinical characteristics of chronic obstructive pulmonary disease （COPD）. Methods From December 2006 to December 2009, at China-Japan Union Hospital of Jilin University 89 stable COPD patients with Hp infection were divided into eradication group and non-eradication group. The eradication group was divided into clarithromycin sub group and moxifloxacin sub group. The patients of these three groups all received regular COPD treatment. Esomeprazole, amoxicillin, clarithromycin and colloidal bismuth citrate were used in clarithromycin group. Esomeprazole, amoxicillin, moxifloxacin and colloidal bismuth citrate were used in moxifloxacin sub group. Patients received pulmonary function test, exercise tolerance evaluation, dyspnea scoring and health-related quality of life scoring at recruitment and 12 months after recruitment. The onset frequenly of acute exacerbation of COPD in one year was counted. The data were analyzed by X^2 test and t test. Results The Hp eradication rate of clarithromycin sub group （48.40%, 15/31） was lower than that of moxifloxacin sub group （87.1%, 27/31）, and the difference was statistically significant （X^2=4.22, P=0. 032）. There was no significant difference percentage of forced expiratory volume in first second to forced vital capacity in （FEV1%） predicted value between 27 cases in non-eradication group and 53 patients with successful Hp eradication （t=0. 677, P= 0.265）. Of 53 pati score and saint Geo 1. 884, 1. 877 and 1 nts with successful Hp eradication, the 6 min walking distance, Borg dyspnea ge＇s respiratory questionnaire （SGRQ） score were improved significantly （t = 773 respectively; P=0.032, 0.025 and 0.034 respectively）, and there was no improvement in 27 non-eradication patients. There was significant difference in the frequency of COPD acute attack between 53 patients with successful Hp eradication （1.2 times） and non-eradication group （1.9 times） （t=l. 812, P=0. 034）. Conclusions Hp eradication therapy with moxifloxacin in COPD patients reached higher Hp eradication rate. Hp eradication in COPD patients with Hp infection can improve the exercise tolerance of patients, relieve dyspnea, improve quality of life and reduce the frenquency of acute attacks.
出处
《中华消化杂志》
CAS
CSCD
北大核心
2012年第10期665-668,共4页
Chinese Journal of Digestion
关键词
螺杆菌
幽门
螺杆菌感染
肺疾病
慢性阻塞性
随访研究
Helicobacter pylori
Helicobacter infections
Pulmonary disease, chronicobstructive
Follow-up studies
