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目的分析儿童幽门螺杆菌(Hp)感染根除失败及再发的主要原因。方法对819例确诊Hp感染的病例,分别选用奥美拉唑、阿莫西林、甲硝唑、克拉霉素进行根除治疗。治疗结束停药4周以上,复查快速尿素酶试验(RUT)1、3C或14C尿素呼气试验(UBT),判断疗效。调查失败病例治疗的顺应性及家庭成员上消化道疾病状况,对根除失败者中的30例行阿莫西林、甲硝唑(MTZ)药物敏感试验;对再发的103例家庭成员168例行血清Hp-IgG及UBT测定。结果 MTZ耐药率为43.33%(13/30),阿莫西林耐药率为6.67%(2/30);未按要求完成治疗者9.61%(5/52),家庭成员中患有上消化道疾病84.62%(44/52)。Hp再发与家庭成员Hp聚集现象有关,家庭成员中Hp阳性检出率为86.31%(145/168)。结论 MTZ的耐药性提高了含MTZ根除方案的失败率;未按要求完成治疗及家庭成员中上消化道疾病感染状况均是导致失败的原因。再发病例与家庭成员Hp检测阳性相关,存在明显的家庭聚集现象。
Objective To analyze the main causes of failure and recurrence of Helicobacter pylori (Hp) infection in children. Methods 819 confirmed cases of Hp infection were selected omeprazole, amoxicillin, metronidazole, clarithromycin for eradication therapy. Treatment over 4 weeks after the withdrawal, review rapid urease test (RUT) 1,3 C or 14 C urea breath test (UBT), to determine the efficacy. To investigate the compliance of treatment failure cases and family members of upper gastrointestinal diseases, 30 cases of loser losers were amoxicillin, metronidazole (MTZ) drug sensitivity test; for the recurrence of 103 cases of family members 168 routine Serum Hp-IgG and UBT determination. Results The resistance rate of MTZ was 43.33% (13/30) and the resistance rate of amoxicillin was 6.67% (2/30). 9.61% (5/52) of the patients who did not finish the treatment as required, Road disease 84.62% (44/52). Hp recurrence and family members Hp aggregation, Hp-positive family members in the detection rate was 86.31% (145/168). Conclusions MTZ resistance increased the failure rate of MTZ eradication program. Failure to complete the treatment and upper gastrointestinal tract infections in family members were the reasons for the failure. Recurrent cases and family members Hp positive test-related, there is a clear phenomenon of family aggregation.