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[目的]通过2种根除幽门螺杆菌(Hp)方案的比较,以期探讨根除方案的优劣及Hp耐药的机制。[方法]139例因各种上消化道症状行胃镜检查并快速尿素酶试验阳性的患者,随机分为2组(符合根除Hp的条件及排除条件),A组67例用奥美拉唑20mg,阿莫西林1g,克拉霉素0.5g;B组72例用奥美拉唑20mg,阿莫西林克拉维酸钾分散片(7∶1)4片,克拉霉素0.5g。均每日2次,共1周。根除结束1个月后,再行13碳-尿素呼气试验,判断Hp的根除效果。[结果]A组根除率为86.57%(58/67),B组为88.89%(64/72),2组比较差异无统计学意义(P>0.05)。[结论]2组Hp根除率无显著性差异,即加入β-内酰胺酶抑制剂并没有显著提高Hp根除率,故Hp可能不产生β-内酰胺酶,其耐药性可能与β-内酰胺酶无关。
[Objective] The purpose of this study was to compare the efficacy of two eradication programs for Helicobacter pylori (Hp) in order to explore the pros and cons of eradication programs and the mechanisms of Hp resistance. [Method] A total of 139 patients with gastroduction due to various upper gastrointestinal symptoms and rapid urease test were randomly divided into 2 groups (in line with the conditions for the eradication of Hp and the exclusion conditions), group A 67 cases with omeprazole 20mg , Amoxicillin 1g, clarithromycin 0.5g; group B, 72 patients with omeprazole 20mg, amoxicillin clavulanate dispersible tablets (7: 1) 4, clarithromycin 0.5g. 2 times a day, a total of 1 week. One month after the end of eradication, another 13 carbon-urea breath test was performed to determine the eradication effect of Hp. [Results] The eradication rate of group A was 86.57% (58/67), while that of group B was 88.89% (64/72). There was no significant difference between the two groups (P> 0.05). [Conclusion] There is no significant difference in Hp eradication rate between the two groups, that is, adding β-lactamase inhibitor did not significantly improve the eradication rate of Hp, so Hp may not produce β-lactamase, its resistance may be related to β-endo Amidase has nothing to do.