| Research Objectives:To study the efficacy and influencing factors of different quadruple eradication programs on elderly HP infected patients.Research Methods:This study included 425 patients who met the inclusion and exclusion criteria at the Department of Gastroenterology,China-Japan Union Hospital of Jilin University from March 2019 to March 2020,and were given quadruple HP treatment.According to the age of the patients,they are divided into 2 groups:(1)Non-elderly group(18 years ≤ age <65 years),(2)Older group(age ≥65 years).The HP eradication program uses a quadruple eradication program(PPI + 2 antibiotics + bismuth agent)for 14 days.All the subjects reviewed the 13 C breath test 4 weeks after the end of the eradication course,and filled out the questionnaire through follow-up before the eradication treatment,at the end of the eradication treatment,and 4 weeks after the end of the eradication treatment.Compare the HP eradication rate of elderly and non-elderly patients and the HP eradication rate of different quadruple schemes in elderly and non-elderly patients.And analyze the incidence of adverse reactions in the eradication of HP in the elderly group and non-elderly group and study the influencing factors of HP eradication.Results:1.The rate of smoking and taking antiplatelet aggregation drugs in elderly patients was higher than that in non-elderly patients.The endoscopic performance of the elderly patients is different from that of the non-elderly group.The incidence of chronic atrophic gastritis,gastric ulcer and Barrett’s esophagus are significantly higher than that of the non-elderly group.The two groups were similar in gender,place of residence,drinking history,and eradication program.2.In the elderly patients,regardless of PP analysis and ITT analysis,the total HP eradication rate of different schemes is 91.8%,which is not significantly different from that of the non-elderly group(<65 years old).3.The comparison of HP eradication rates of different quadruple programs showed that the total HP eradication rate of PAFB eradication program was 94.1%,which was significantly higher than that of PAKB eradication program,P <0.05,but no statistical difference from PKFB eradication program,P> 0.05.There was no statistical difference in total HP eradication rate between the PAKB and PKFB eradication programs,P> 0.05.Further analysis of the eradication rate of patients of different ages showed that there was no significant difference in the eradication rate of elderly patients using PAFB,PAKB and PKFB eradication programs,all P> 0.05.The eradication rate of the PAFB eradication program in non-elderly patients was 94.0%,which was significantly higher than that of the PAKB eradication program,P <0.05,but there was no statistical difference from the PKFB eradication program,P> 0.05.There was no statistical difference in total HP eradication rate between the PAKB and PKFB eradication programs,P> 0.05.However,when the same quadruple eradication program was applied,the HP eradication rate of elderly patients was not statistically different from that of non-elderly patients,with P> 0.05.4.A total of 419 patients in this study completed this experiment.A total of 50 patients had adverse reactions.Adverse reactions are mainly nausea,vomiting,abdominal pain,bloating,diarrhea,constipation,rash,fatigue,and dizziness.The incidence of total adverse reactions in the elderly group was 23.5%,which was significantly higher than that in the non-elderly group,P <0.001.In terms of the occurrence of adverse reactions of abdominal distension,the highest incidence rate of the elderly is 15.3%,which is significantly higher than that of the non-elderly group,P <0.05.The elderly group had higher incidence of abdominal pain,diarrhea,constipation,rash and fatigue than non-elderly group,and there was no statistical difference between the two groups.All patients had mild adverse reactions and could tolerate them without discontinuation of medication or other special treatments.After the eradication,the adverse reactions gradually resolved and disappeared.5.Include smoking history,place of residence,age,whether to take anti-platelet aggregation drugs,gastroscopy results,eradication program into a multivariate analysis.The application of PAKB eradication program and smoking are risk factors that affect the eradication rate of HP.Age is not a risk factor affecting HP eradication rate.Conclusions:1.The eradication rate of Helicobacter pylori in the elderly is not statistically different from that in the non-elderly.2.The incidence of adverse reactions of Helicobacter pylori eradication in the elderly is higher than that in non-elderly people.3.Application of PAKB eradication program and smoking are independent risk factors affecting HP eradication rate. |
