Helicobacter pylori eradikasyonunda sukralfat`ın üçlü tedavideki yeri

Abstract

ÖZET S.B. Ankara Hastahanesi Gastroenteroloji bölümünde dispeptik şikayetleri olan ve son bir ayda anti-ülser ilaç, antibiyotik ve/veya kolloidal bizmut sitrat kullanmamış 58 hastadan alınan endoskopik biyopsi materyalleri histopatoloji, hızlı üreaz testi (CLO-Test)®, kültür ve yayma preparat yöntemleri ile incelendi ve sonuçta 46 hasta H.pylori yönünde (+) bulundu. H. pylori (+) bulunan 46 hasta iki gruba ayrılarak 1. gruba amoksisilin tb 3x500 mg 14 gün, metranidazol tb 2x500 mg 10 gün ve kolloidal bizmut sitrat tb 4x300 mg 30 gün süreyle, 2. gruba amloksisilin tb 3x500 mg 14 gün, metranidazol tb 2x500 mg 10 gün ve sükralfat tb 2x2 gr 30 gün süreyle uygulandı. Tedavi bitiminden 4 hafta sonra yapılan kontrollerde 1. grupta 23 hastanın 19'unda (%82.60), 2. grupta 23 hastanın 18'inde (%78.26) eradikasyon sağlandı. iki gruptaki eradikasyon yüzdeleri arasındaki fark istatistiksel olarak anlamlı bulunmadığından sonuç olarak sükralfat'ın üçlü tedavi protokolünde kolloidal bizmut subsitrata alternatif olabileceği düşünülmüştür. 38

SUMMARY 58 Consequtive patients with gastroduodenal disorders were underwent upper gastrointestinal endoscopy at Ministery of Health, Ankara Hospital, Gastroenterology department the patients taking antiulcer drugs, antibiotics or colloidal bismuth subcitrate within 4 weeks of endoscopic examination were excluded from the study. At each endoscopy, four antral biopsies were taken and biopsy materials were underwent examinations by rapid urease (CLO-Test)®, histopathology, culture and smear tecnigues. By these way 46 patients were found H.pylori positive. H. pylori positive patients were divided in two groups. We gave amoxicillin tb 3x500 mg for 14 days, metranidazole tb 2x500 mg for 10 days and colloidal bismuth subcitrate tb 4x300 mg for 30 days to 1st group patients. And amoxicillin tb 3x500 mg for 14 days, metranidazol tb 2x500 mg for 10 days and sucralfate tb 2x2 gr for 30 days to 2nd group patients. A control endoscopy and other examination methods were made subsequently 4 weeks after treatment had been completed in these controls we found that; 19 of 23 patients in 1st group and 18 of 23 patients in 2nd group were eradicated from H. pylori (%82.60 and %78.26). These differences were statically insignificant, thereby it was considered that sucralfate is an alternative drug for colloidal bismuth subcitrate in thriple therapy. 39