Helicobacter pylori eradikasyon tedavisinde lansoprozol, klaritromisin ve amoksisilin ile ranitidin bizmut sitrat, lansoprozol, klaritromisin ve amoksisilin rejimlerinin etkinliginin karsilastirilmasi
The comparison of lansoprazole, clarithromycin and amoxicillin with ranitidine bismuth citrate, lansoprazole, clarithromycin and amoxicillin for Helicobacter pylori eradication therapy
- Ana Sayfa
- Sayılar
- Helicobacter pylori eradikasyon tedavisinde lansoprozol, klaritromisin ve amoksisilin ile ranitidin bizmut sitrat, lansoprozol, klaritromisin ve amo...
Baskent Üniversitesi Tip Fakültesi Gastroenteroloji Bilim Dali3, Ankara
Özet
Giris ve amaç: Helicobacter pylori (H. pylori) eradikasyon orani bölgelere ve tedavi rejimlerine göre farkliliklar göstermektedir. Bu çalismadaki amacimiz farkli tedavi rejimlerinin etkinligini karsilastirmaktir. Gereç ve yöntem: Çalismaya hizli üreaz testi ve/veya histopatoloji ile H. pylori pozitif oldugu gösterilen dispeptik hastalar alindi. Hastalar iki gruba ayrildi. Grup A’ya lansoprozol 2x30 mg, klaritromisin 2x500 mg, amoksisilin 2x1000 mg, grup B’ye lansoprozol 2x30 mg, klaritromisin 2x500 mg, amoksisilin 2x1000 mg, ranitidin bismuth sitrat 2x400 mg 14 gün süreyle verildi. Tedavi bitiminden 4 hafta sonra kontrol endoskopi yapilarak histopatolojik olarak H. pylori durumu arastirildi. Bulgular: Çalismaya nonülser dispepsisi olan 49 erkek, 86 kadin, toplam 135 hasta alindi. Çalismaya alinan hastalarin endoskopik olarak 56 (%41,5)’sinda antral gastrit, 79 (%58,5)’unda pangastrit saptandi. Pangastriti olanlari n 51(%64)’inde; antral gastriti olanlarin 32 (%57)’sinde eradikasyon saglandi. Eradikasyon oranlari grup A ve B’de sirasi ile %56, %68 p=0,099 bulundu. Grup A ve B’de yas ortalamasi ve erkek/kadin orani sirasiyla (41,2±11vs 42,1±12) (25/50 vs 24/36) idi. Grup A’da %58,6 antral gastrit, %41,3 pangastrit, grup B’de %20 antral gastrit, %80 pangastrit vardi. Sonuç: Bismuth içeren tedavi grubunda eradikasyon basari orani sayisal olarak daha yüksek olmakla beraber istatistiki fark saptanmami s olup eradikasyon oranlari genel literatüre göre düsük bulunmustur.
Abstract
Background/aim: The eradication rate of Helicobacter pylori (H. pylori) shows variation in different geographic regions and treatment regimens. We aimed to study the eradication rates of different regimens in our region. Materials and methods: One hundred and thirty-five H. pylori positive patients (49 males, 86 females; mean age: 41,7±12 years) with non-ulcer dyspepsia were included in the study. The patients were divided into two groups according to the treatment regimens. Lansoprozole 30 mg, clarithromycin 500 mg, amoxicilin 1 g were given twice daily for 2 weeks (group A). Patients in group B recevied ranitidine bismuth subcitrate 400 mg, lansoprozole 30 mg, clarithromycin 500 mg, amoxicilin 1 g twice daily for 2 weeks. Two biopsies each before and after treatment were obtained from antrum and corpus, and histopathologically evaluated. Eradication was assumed to be successful if no H. pylori was detected from four biopsy specimens taken after treatment. Results: The overall eradication rate was 61,5%. The rates of eradication were 56%, 68% p=0,099 in groups A and B, respectively. Fifty-six patients (41,5%) were had antral gastritis and 79 (58,5%) patients had pangastritis. Mean ages and male/ female ratio (41,2±11 vs 42,1±12, p=NS) (25/50 vs 24/36, p=NS) in groups A and B, respectively. No correlation between sex and H. pylori eradication was found. Conclusion: The rate of eradication in group B was higher than group A, but not statistically significant. However, our rates of eradication were significantly lower compared to those reported in literature.
