·论着·JMedRes,February2024,Vol.53No.2高剂量二联疗法首次根除幽门螺杆菌疗效和安全性Meta分析霍鲁月吴胜男庄帅帅孙为豪摘要目的系统评价高剂量二联疗法（high－dosedualtherapy,HDDT）与四联疗法（quadrupletherapy，QT）对比治疗首次幽门螺杆菌（helicobacterpylori,Hp）感染的疗效和安全性。方法检索中国知网、万方数据知识服务平台、维普网、CBM、PubMed、Embase、CochraneLibrary等数据库，收集关于HDDT对比QT治疗Hp感染的随机对照试验（randomizedcontrolledtrial，RCT），检索时间从建库至2022年7月3日。采用RevMan5.4和Stata17.0软件进行Meta分析。结果共纳人11篇文献，4015例患者。Meta分析结果显示,在意向性治疗分析中,HDDT根除率优于QT,且差异有统计学意义(RR=1.04,95%CI:1.01~1.06,P<0.01)；在符合方案分析中,两组根除率比较差异无统计学意义（RR=1.02,95%CI:1.00~1.04,P=0.08）。从不良反应发生率来看,HDDT较QT显著降低,且差异有统计学意义（RR=0.47,95%CI:0.36~0.61,P<0.01）。从依从性上比较,两组均具有良好的依从性，差异无统计学意义（RR=1.01,95%CI:1.00~1.02,P=0.06）。结论HDDT首次根除Hp感染的疗效优于QT,且安全性更好，可作为一线治疗方案应用于临床。关键词幽门螺杆菌高剂量二联疗法四联首次中图分类号R573Meta-analysisoftheEfficacyandSafetyofHigh-doseDualTherapyfortheFirst-lineHelicobacterpyloriInfection.HUOLuyue,WUShengnan,ZHUANGShuaishuai,etal.DepartmentofGeriatricGastroenterology,TheFirstAffiliatedHospitalofNanjingMedicalUniversi-ty,Jiangsu210029,ChinaAbstractObjectiveTosystematicallyevaluatetheefficacyandsafetyofhigh-dosedualtherapy(HDDT)versusquadruplether-apy(QT)forthefirst-linehelicobacterpylori(Hp)infection.MethodsTherandomizedcontrolledtrial(RCT)aboutHDDTversusQTforthefirst-linetreatmentofHpinfectionweresearchedfromCNKI,VIP,Wanfang,CBM,PubMed,Embase,CochraneLibraryandotherdatabasesfromtheestablishmentofdatabasesto3July2022.RevMan5.4andStata17.OsoftwarewereusedforMeta-analysis.ResultsAtotalof11studieswith4015patientswereincluded.TheresultsofMeta-analysisshowedthat:theeradicationrateofHDDTwasstatisticallysuperiortothatofQT(RR=1.04,95%CI:1.01-1.06,P<0.01)intheintention-to-treatanalysis;theeradica-tionrateofthetwogroupswasnot...
