中华消化杂志
中華消化雜誌
중화소화잡지
Chinese Journal of Digestion
2012年
10期
665-668
,共4页
王静%季尚玮%谭平%李岩%王江滨
王靜%季尚瑋%譚平%李巖%王江濱
왕정%계상위%담평%리암%왕강빈
螺杆菌,幽门%螺杆菌感染%肺疾病,慢性阻塞性%随访研究
螺桿菌,幽門%螺桿菌感染%肺疾病,慢性阻塞性%隨訪研究
라간균,유문%라간균감염%폐질병,만성조새성%수방연구
Helicobacter pylori%Helicobacter infections%Pulmonary disease,chronic obstructive%Follow-up studies
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x2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(x2=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6 min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(1.9次)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.
目的 比較不同治療方案對慢性阻塞性肺病(COPD)患者Hp感染的根除率,探討成功根除Hp對COPD患者臨床特徵的影響.方法 選取2006年12月至2009年12月吉林大學中日聯誼醫院Hp感染的穩定期COPD患者89例併分為根除組和不根除組,其中根除組又分為剋拉黴素組和莫西沙星組.三組皆接受常規COPD治療.剋拉黴素組聯用埃索美拉唑、阿莫西林、剋拉黴素、膠體次枸櫞痠鉍.莫西沙星組聯用埃索美拉唑、阿莫西林、膠體次枸櫞痠鉍、莫西沙星.患者分彆在入組時及隨訪12箇月時接受肺功能檢測、運動耐力評價、呼吸睏難評分、健康相關生活質量評分,併統計1年內COPD急性髮作的次數.統計學處理採用x2檢驗和t檢驗.結果 剋拉黴素組Hp根除率[48.4％(15/31)]低于莫西沙星組[87.1％(27/31)],差異有統計學意義(x2=4.22,P=0.032).27例不根除組患者第1秒用力呼氣容積佔預計值百分比的下降程度與53例成功根除Hp者比較差異無統計學意義(t=0.677,P=0.265).入組時與隨訪12箇月時比較,53例成功根除Hp者6 min步行距離、Borg呼吸睏難評分、聖喬治呼吸問題調查問捲總評分均穫有統計學意義的改善(t=1.884、1.877、1.773,P=0.032、0.025、0.034),27例不根除組患者則皆未穫改善.53例成功根除Hp者1年內平均COPD急性髮作次數(1.2次)與不根除組(1.9次)比較差異有統計學意義(t=1.812,P=0.034).結論 COPD患者接受含莫西沙星的Hp根除方案或可穫較高的Hp根除率.Hp感染的COPD患者根除Hp可在一定程度上提高運動耐力,減輕呼吸睏難,提高生活質量,減少急性髮作次數.
목적 비교불동치료방안대만성조새성폐병(COPD)환자Hp감염적근제솔,탐토성공근제Hp대COPD환자림상특정적영향.방법 선취2006년12월지2009년12월길림대학중일련의의원Hp감염적은정기COPD환자89례병분위근제조화불근제조,기중근제조우분위극랍매소조화막서사성조.삼조개접수상규COPD치료.극랍매소조련용애색미랍서、아막서림、극랍매소、효체차구연산필.막서사성조련용애색미랍서、아막서림、효체차구연산필、막서사성.환자분별재입조시급수방12개월시접수폐공능검측、운동내력평개、호흡곤난평분、건강상관생활질량평분,병통계1년내COPD급성발작적차수.통계학처리채용x2검험화t검험.결과 극랍매소조Hp근제솔[48.4％(15/31)]저우막서사성조[87.1％(27/31)],차이유통계학의의(x2=4.22,P=0.032).27례불근제조환자제1초용력호기용적점예계치백분비적하강정도여53례성공근제Hp자비교차이무통계학의의(t=0.677,P=0.265).입조시여수방12개월시비교,53례성공근제Hp자6 min보행거리、Borg호흡곤난평분、골교치호흡문제조사문권총평분균획유통계학의의적개선(t=1.884、1.877、1.773,P=0.032、0.025、0.034),27례불근제조환자칙개미획개선.53례성공근제Hp자1년내평균COPD급성발작차수(1.2차)여불근제조(1.9차)비교차이유통계학의의(t=1.812,P=0.034).결론 COPD환자접수함막서사성적Hp근제방안혹가획교고적Hp근제솔.Hp감염적COPD환자근제Hp가재일정정도상제고운동내력,감경호흡곤난,제고생활질량,감소급성발작차수.
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 x2 test and t test.Results The Hp eradication rate of clarithromycin sub group (48.4 ％,15/31) was lower than that of moxifloxacin sub group (87.1％,27/31),and the difference was statistically significant (x2 =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 patients with successful Hp eradication,the 6-min walking distance,Borg dyspnea score and saint George's respiratory questionnaire (SGRQ) score were improved significantly (t =1.884,1.877 and 1.773 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=1.812,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.
