Hp Eradikasyonu Ve Ülser İyileşmesinde Ranitidin-Bizmut Sitrat İle Ranitidin Arasında Anlamlı Fark Var Mıdır ?

Abstract

İnönü Üniversitesi Gastroenteroloji kliniğine başvuran ve yapılan endoskopilerinde duodenal yada gastrik ülser tespit edilen ve endoskopik biyopsilerinde Hp (+) bulunan yaş ortalaması 37 olan 56 hasta rastgele iki guruba ayrılarak birinci guruptaki 30 hastaya 1 ay süre RBS 2 x 400 mg/gün + 1 hafta Klaritromisin 2 x 500 mg/gün + lhafta 2x1 gr Amoksisilin verildi. İkinci guruptaki 26 hastaya ise 1 hafta Klaritromisin 2 x 500 mg/gün + Amoksisilin 2 xl gr/gün + 1 ay Ranitidin 2 x 300 mg/gün verildi. Tedavi bitiminden 2 hafta sonra tüm olgularda endoskopik biyopsi tekrarlandı ve Hp (-) olanlarda eradikasyon sağlandığı kabul edildi. Birinci guruptaki olgularda 6 hafta sonunda Hp eradikasyon oram % 100 (24/24), ikinci grupta % 69.5 (16/23) idi ve iki gurup arasındaki fark istatistiksel olarak anlamlı idi. Ülser iyileşme oranlan ise birinci gurupta %100 (24/24), ikinci gurupta ise % 86.9 (20/23) idi ve bu fark da istatistiksel olarak anlamlı bulundu (p<0.05).

Fifty-six patients admitted to Inonu University Gastroenterology Department and detected duodenal or gastric ulcer in their endoscopies with Helicobacter pylori positivity in their endoscopic biopsies included in the study. The mean age of the patients was 37. Patients were divided in to two groups. Of 30 patients in the fírst group were given ranitidine bismuth citrate (RBC), 400 mg twice daily for one month, plus clarithromycin, 500 mg twice daily for one week, and amoxicillin, 1 gr twice daily for one week. Of 26 patients in the second group were given ranitidine, 300 mg twice daily for one month, plus clarithromycin, 500 mg twice daily for one week, and amoxicillin, 1 gr twice daily for one week. Endoscopic biopsies were repeated two weeks later at the end of the therapy and it was accepted as H. Pylori eradicated in negative biopsies. The H. pylori eradication rate was 100 % (24/24) in the first group and 69.5 % (16/23) in the second group with statistically significant difference. Ulcer healing rate was 100 % (24/24) in the first group and 86.9 % (20/23) in the second group with statistically significant difference. Both two regimens were well tolerated.