궤양과 소화불량 환자에서 헬리코박터 제균율의 차이
Difference in Helicobacter pylori eradication rates in patients with peptic ulcer and non-ulcer dyspepsia
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목적 : Helicobacter pylori (H. pylori) 제균 치료에 있어서 적절한 제균율을 유지하는 것은 매우 중요하다. H. pylori 제균율이 소화성 궤양 환자와 비궤양성 소화불량 환자에서 차이가 있다는 외국의 보고가 다수 있었으나 이에 대한 국내의 연구는 없었다. 대다수 연구의 제균율은 궤양 환자를 대상으로 한 것이며, 치료제의 종류 및 사용기간에 대한 합의도 이러한 연구들로부터 도출된 것이다. 본 연구에서는 소화성 궤양 환자와 비궤양성 소화불량 환자에서 H. pylori 제균율의 차이가 있는가를 알아보고자 하였다. 방법 : 2003년 6월부터 2004년 5월까지 분당서울대학교병원에서 내시경 검사를 시행하고 7일간의 proton pump inhibitor(PPI)+amoxacillin+clarithromycin 치료를 받은 후 효소호기검사로 제균여부를 확인한 297명을 대상으로 후향적 연구를 하였다.결과 : 소화성 궤양 환자는 237명(위궤양 98명, 십이지장궤양 167명, 양쪽 모두 28명), 비궤양성 소화불량 환자는 60명이었으며 제균율은 각각 85.7% (95% CI 80.6∼89.6%), 73.3% (95% CI 61.0∼82.9%)로 비궤양성 소화불량 환자의 제균율이 낮았다(p=0.032).
Abstract
Background : Physicians should try to achieve an optimal cure rate with their initial Helicobacter pylori (H. pylori) eradication therapy. Most physicians tend to use the same combination of drugs. There have been several reports that H. pylori infection in patients with peptic ulcer disease (PUD) is more likely to be cured than that in patients with non-ulcer dyspepsia (NUD). However, there is no report in Korea about that issue. The aim of this study was to evaluate the difference of eradication rates of H. pylori between patients with PUD and patients with NUD in Korea. Methods : 297 patients who underwent upper gastrointestinal endoscopy, treated with seven-day triple therapy (proton pump inhibitor+amoxicillin+clarithromycin), and then performed follow-up urea breath test were reviewed retrospectively. Results : 237 of 297 patients were PUD (98 gastric ulcers, 167 duodenal ulcers, 28 both ulcers), and 60 of 297 patients were NUD. The eradication rates were 85.7% (95% CI 80.6～89.6%) and 73.3% (95% CI 61.0～82.9%), respectively. The eradication rate of NUD group was lower than that of PUD group (p=0.032). Conclusions : Seven-day triple therapy showed lower eradication rate in patients with NUD than patients with PUD. Therefore, extention of treatment duration or use of more potent regimen may be needed for eradication of H. pylori in patients with NUD.(Korean J Med 70:505-510, 2006)
참고문헌 (17)
- "국내에서 Helicobacter pylori 감염 현황과 치료", 39, pp.153~160 (2002)
- "Helicobacter pylori 기초와 임상의 실제" (2001), 군자출판사
- "한국인에서의 Helicobacter pylori 감염의 진단 및 치료.", 32, pp.275~289 (1998)
- "Helicobacter pylori 일ㆍ이차 제균요법 실패 후 Moxifloxacin 포함 삼제병합요법 시도.", 45, pp.111~117 (2005)
- "Is Helicobacter pylori associated with non-ulcer dyspepsia and will eradication improve symptoms?: a meta- analysis", 319, pp.1040~1044 (1999)
- "Eradication therapy should be different for dyspeptic patients than for ulcer patients.", 17 (2003)
- "Helicobacter pylori eradication therapy is more effective in peptic ulcer than in non-ulcer dyspepsia", 13, pp.1303~1307 (2001)
- "Seven-day therapy for Helicobacter pylori in the United States", 20, pp.99~107 (2004)
- "Do patients with non-ulcer dyspepsia respond differently to Helicobacter pylori eradication treatments from those with peptic ulcer disease?: a systematic review.", 11, pp.2726~2732 (2005)
- "Microbiological factors that influence the eradication of Helicobacter pylori in adults and children", 20, pp.431~434 (2002)
- "Factors that may affect treatment outcome of triple Helicobacter pylori eradication therapy with omeprazole, amoxicillin, and clarithromycin", 45, pp.63~67 (2000)
- "Patient factors affecting Helicobacter pylori eradication with triple therapy", 88, pp.505~509 (1993)
- "Clinical outcome and influencing factors of a new short-term quadruple therapy for Helicobacter pylori eradication: a randomized controlled trial (MACLOR study).", 162, pp.153~160 (2002)
- "Factors affecting Helicobacter pylori eradication using a seven-day triple therapy with a proton pump inhibitor, tinidazole and clarithromycin, in Brazilian patients with peptic ulcer.", 56, pp.11~16 (2001)
- "Treatment of Helicobacter pylori infection and factors influencing eradication", 16, pp.24~30 (2002)
- "Implications of Helicobacter pylori serological titer for the histological severity of antral gastritis", 29, pp.27~30 (1997)
- "Current concepts in the management of Helicobacter pylori infection-the Maastricht 2-2000 Consensus Report", 16, pp.167~180 (2002)