Clinical Endoscopy

  • 제41권1호
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  • Pages.5-9
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  • 2010
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  • 2234-2400(pISSN)
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  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
권호 표지

최근 H. pylori 에 대한 1차 삼제요법의 연도별 제균율 변화와 기간에 따른 제균율 비교

Recent Eradication Rates of First-line Triple Regimens for H. pylori Infection

  • 백나영 (동국대학교 의과대학 가정의학교실) ;
  • 임윤정 (동국대학교 의과대학 내과학교실) ;
  • 이종호 (동국대학교 의과대학 내과학교실) ;
  • 강지훈 (동국대학교 의과대학 내과학교실) ;
  • 박정배 (동국대학교 의과대학 내과학교실) ;
  • 이진호 (동국대학교 의과대학 내과학교실)
  • Paek, Na-Young (Department of Family Medicine, Dongguk University-Seoul, Graduate School of Medicine) ;
  • Lim, Yun-Jeong (Department of Internal Medicine, Dongguk University-Seoul, Graduate School of Medicine) ;
  • Lee, Jong-Ho (Department of Internal Medicine, Dongguk University-Seoul, Graduate School of Medicine) ;
  • Kang, Ji-Hun (Department of Internal Medicine, Dongguk University-Seoul, Graduate School of Medicine) ;
  • Park, Jeong-Bae (Department of Internal Medicine, Dongguk University-Seoul, Graduate School of Medicine) ;
  • Lee, Jin-Ho (Department of Internal Medicine, Dongguk University-Seoul, Graduate School of Medicine)
  • 투고 : 2010.02.17
  • 심사 : 2010.06.21
  • 발행 : 2010.07.30
⟨ 이전 논문 다음 논문 ⟩

초록

목적: 최근 Helicobacter pylori (H. pylori) 1차 삼제요법의 제균율이 감소하는 경향을 보이고 있어 치료 기간의 연장을 권고하고 있다. 시기별 지역과 인종에 따라 제균율의 차이를 보이고 있어 시기적절하게 그 지역의 제균율 조사가 이루어져야 하고 그 결과에 따라 적절한 제균요법을 권고해야 한다. 경기 북서부 지역의 단일 기관의 최근 4년간의 1차 제균요법(proton pump inhibitor (PPI), amoxicillin, clarithromycin)의 제균율을 알아보았다. 대상 및 방법: 2005년 11월 1일부터 2009년 10월 31일까지 단일 기관, 대학병원에서 PPI (lansoprazole 60 mg or pantoprazole 80 mg), amoxicillin 2,000 mg, clarithromycin 1,000 mg 삼제요법 2주일과 1주일 처방을 받은 환자들의 제균율을 조사하였다. 제균 후 판정은 제균 치료 4~6주 후에 $^{13}C-$요소호기검사로 하였다. 결과: PPI, amoxicillin, clarithromycin 제균율은 80.4%(785/976)였다. 1주일 제균요법의 제균율은 2005년 11월 1일~2007년 10월 31일 동안 83.1%(422/508)이나, 2007년 11월 1일~2009년 10월 31일은 73.3%(198/270)으로 제균율 감소를 볼 수 있었다(p<0.01). 2007년 11월 1일부터 2009년 10월 31일까지 2주일 제균율은 83.3%(165/198)로 1주일 제균율보다 통계적으로 유의하게 높게 나타났다(p＜0.01). 결론: 경기 북서부 지의 1차 1주일 제균요법의 제균율은 73.3%(198/270)로 나타나 만족스럽지 못하고 2주일로 치료기간의 연장하였을 때 제균율이 증가해 삼제요법 2주 처방이 바람직하다.

Background/Aims: Decreasing trend of eradication rate of H. pylori using first-line triple regimens (proton pump inhibitor, amoxicillin, clarithromycin) has been issued. Longer therapies may become more popular if there are better results. Recent eradication rate should be examined and proper recommendation should be timely done according to the result. Methods: We examined recent eradication rates of first-line triple regimens and compared eradication rate according to the duration of this first-line therapy for H. pylori infection. The 976 patients received first-line triple therapy at the single center from November, 2005 to October, 2009 were retrospectively analyzed. Urea breath test was done at four to six weeks after completion of eradication therapy. Results: Overall eradication rate of triple regimen by intention to treat analysis was 80.4% (785/976). One week eradication rate has decreasing trend and below 73.3% during recent 2 years. Eradication rate in 2 weeks group (83.3%, 165/198) was significantly higher than 1 week group (73.3%, 198/270) from November, 2007 to October, 2009 (p<0.01). Conclusions: Our results showed that 2 weeks triple regimen should be preferred as first-line therapy for H. pylori eradication.

키워드

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