헬리코 박터 균 제거 후 언제 또 재발하나 ? 가장 제균이 잘되는 항균 요법은? > 임상 응용 정보

헬리코 박터 균 제거 후 언제 또 재발하나 ? 가장 제균이 잘되는 항균 요법은?

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헬리코 박터 균 제거 후 언제 또 재발하나 ?
 
 가장 제균이 잘되는 항균 요법은?
  
 <IMG style="WIDTH: 499px; HEIGHT: 349px" src="/_dimg/4-1%2020150217_205627.png" width=498 height=286>
 
위장 궤양 과 위 암 발병 균인 헬리코 박터 균 제거 문제는
 항상 두 가지 문제 점을 안고 지내 왔다
 
하나는 항균 요법 중 어떤 방법이 가장 효과적인가 라는 점이다
 
또 하나는 일단 균이 제거된 후 언제 또 다시 재발하느냐라는 문제 였다
 
다행히도 이 두 가지 문제의 해답이 동시에 밝혀 졌다
 
이는 미국 보건성 지원하에 실시된 대 단위 비교 임상 결과가
 미국 의사 회 학술 지 를 발표된 것이;다 
 
 <IMG style="WIDTH: 512px; HEIGHT: 456px" src="/_dimg/4-2%2020150217_205705.png" width=511 height=341>
[그림]  Helico 균이 발병시키는 병
급만성 위염, 위축성 위;염 12지장 궤양, 위암 핌프 종양  
 
 
재발 율 1년 내에 11.5%
 
 1 년 전 헬리코 제균 요법을 받았던 자 1,091 명 을 대상으로
 재발 율을 검사한 결과 아래 표에서 처럼 11.5%가 
 1년내에 재발 감염을 일크켰음이 밝혀 졌다
 
 
따라서 2년 후 3년 후의 제발 율이 어떻게 될 것인가는 
 계속적인 임상을 통해 밝혀 낼 전망이다
 
여하간 한 번 제균 치료를 받았다 할지라도 
 1년 이후에는 재 검진 할 필요가 있는 것이다
 
<TABLE style="WIDTH: 487.35pt; BORDER-COLLAPSE: collapse; mso-yfti-tbllook: 1184; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt" Table border=0 cellSpacing=0 cellPadding=0 width=650>
<TBODY>
<TR style="mso-yfti-irow: 0; mso-yfti-firstrow: yes">
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 487.35pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ccffff; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: windowtext 1pt solid; " width=650 colSpan=2>
제균 후 음성 자중 1년 동안에 재 감염된 자 . </TD></TR>
<TR >
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 168.45pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ff99ff; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=225>
제균자 </TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 318.9pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ff99ff; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=425>
1,091명 </TD></TR>
<TR >
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 168.45pt; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=225>
1년중 양성 자</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 318.9pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #66ff66; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=425>
125명 (11.5%) </TD></TR>
<TR >
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 487.35pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #f2f2f2; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=650 colSpan=2>
-1년전 헬리코 제균 요법 받았던자 1091명 을 대상
-건강 상태가 후진 지역인 중남미 7개 지역 주민을 대상
-제균 요법 실시 기간 :2009 9월 -2011년 7월 </TD></TR>
<TR style="mso-yfti-irow: 4; mso-yfti-lastrow: yes">
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 487.35pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #f2f2f2; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=650 colSpan=2>
임상 기관: 미국 미시간 의대,. 배더빌트 의대, 노스 캘로리나 의대
워싱톤 의대(시애틀)및 맥시코 등 7개 지역 의료 기관 </TD></TR></TBODY></TABLE>
 
 
 <IMG style="WIDTH: 526px; HEIGHT: 464px" src="/_dimg/4-3%2020150217_205744.png" width=525 height=343>
  [그림] 헬리코 균은 산성 조건하에서는 깊숙히 침투하여 숨어 버림으로 제균시에는 위산을 없새야만 균이 외부로 나오므로 제균하기 용이해진다 
;
 
 
약물 요법 간 약효 비교
 
항균 제 약물 요법은 아래 표에서 처럼 3가지 종류로 분류되나
 핼키코균 음성 화율로서 가장 높은 것이 14일 요법이다
 
그러나 다른 요법과의 차이는 별로 없는 것으로 나타났다ㅣ
 
<TABLE style="WIDTH: 522.8pt; BORDER-COLLAPSE: collapse; mso-yfti-tbllook: 1184; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt" Table border=0 cellSpacing=0 cellPadding=0 width=697>
<TBODY>
<TR style="mso-yfti-irow: 0; mso-yfti-firstrow: yes">
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 522.8pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ccffff; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: windowtext 1pt solid; " width=697 colSpan=4>
제균 1년후 음성 자 (제균 요법의 효율</TD></TR>
<TR >
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 90.45pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ff99ff; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=121>
 </TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 99.25pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ff99ff; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=132>
음성 자</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 70.85pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ff99ff; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=94>
음성 율</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 262.25pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ff99ff; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=350>
처방 </TD></TR>
<TR >
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 90.45pt; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=121>
14일 요법</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 99.25pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ddd9c3; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; mso-background-themecolor: background2; mso-background-themeshade: 230" width=132>
488명중 364명</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 70.85pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #66ff66; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=94>
74.6%</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 262.25pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #fde9d9; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=350>
Lansoprazole + Amoxicillin
+ Clarithromycin  (3종 동시)</TD></TR>
<TR >
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 90.45pt; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=121>
10일 요법</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 99.25pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ddd9c3; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; mso-background-themecolor: background2; mso-background-themeshade: 230" width=132>
486명중 356명</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 70.85pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #66ff66; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=94>
73.3%</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 262.25pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #fde9d9; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=350>
전 5일:2종 Lansoprazole + Aamoxicillin 
후 5일4종  Lansoprazole +Clarithromycin, 
+Metronidazole </TD></TR>
<TR >
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 90.45pt; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=121>
5일 요법</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 99.25pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ddd9c3; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; mso-background-themecolor: background2; mso-background-themeshade: 230" width=132>
489명중 343명</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 70.85pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #66ff66; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=94>
70.1%</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 262.25pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #fde9d9; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=350>
Lansoprazole, + Amoxicillin,
+Clarithromycin + Metronidazole(4종동시)</TD></TR>
<TR >
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 90.45pt; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=121>
전체  평균</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 99.25pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ddd9c3; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; mso-background-themecolor: background2; mso-background-themeshade: 230" width=132>
1463명중 1063명</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 70.85pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #66ff66; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=94>
72.7%</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 262.25pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #fde9d9; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=350>
 </TD></TR>
<TR style="mso-yfti-irow: 6; mso-yfti-lastrow: yes">
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 522.8pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #f2f2f2; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=697 colSpan=4>
<TABLE style="MARGIN: auto auto auto 12.5pt; BORDER-COLLAPSE: collapse; mso-yfti-tbllook: 1184; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt" Table border=0 cellSpacing=0 cellPadding=0>
<TBODY>
<TR style="mso-yfti-irow: 0; mso-yfti-firstrow: yes">
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 3cm; PADDING-RIGHT: 5.4pt; BACKGROUND: #ff66ff; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: windowtext 1pt solid; " width=113>
 </TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 114.85pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ff66ff; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: windowtext 1pt solid; " width=153>
14일 요법</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 6cm; PADDING-RIGHT: 5.4pt; BACKGROUND: #ff66ff; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: windowtext 1pt solid; " width=227 colSpan=2>
10일 요법</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 106.3pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ff66ff; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: windowtext 1pt solid; " width=142>
5일 요법</TD></TR>
<TR >
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 3cm; PADDING-RIGHT: 5.4pt; BACKGROUND: #ddd9c3; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid; mso-background-themecolor: background2; mso-background-themeshade: 230" width=113>
 </TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 114.85pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ddd9c3; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid; mso-background-themecolor: background2; mso-background-themeshade: 230" width=153>
 </TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 77.95pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ddd9c3; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid; mso-background-themecolor: background2; mso-background-themeshade: 230" width=104>
전 5일</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 92.15pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ddd9c3; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid; mso-background-themecolor: background2; mso-background-themeshade: 230" width=123>
후5일</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 106.3pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ddd9c3; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid; mso-background-themecolor: background2; mso-background-themeshade: 230" width=142>
 </TD></TR>
<TR >
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 3cm; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid; " width=113>
Lansoprazole</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 114.85pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #fbd4b4; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid; " width=153>
1일 2회
1화 30mg</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 77.95pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #fbd4b4; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid; " width=104>
1일 2회
1화 30mg</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 92.15pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #fbd4b4; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid; " width=123>
1일 2회
1화 30mg</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 106.3pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #fbd4b4; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid; " width=142>
1일 2회
1화 30mg</TD></TR>
<TR >
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 3cm; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid; " width=113>
Amoxicillin
 </TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 114.85pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #fbd4b4; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid; " width=153>
1일 2회
1화 2g</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 77.95pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #fbd4b4; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid; " width=104>
1일 2회
1화 2g</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 92.15pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #fbd4b4; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid; " width=123>
 </TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 106.3pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #fbd4b4; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid; " width=142>
1일 2회
1화 2g</TD></TR>
<TR >
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 3cm; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid; " width=113>
Clarithromycin</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 114.85pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #fbd4b4; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid; " width=153>
1일 2휘
1회 500mg</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 77.95pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #fbd4b4; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid; " width=104>
 </TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 92.15pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #fbd4b4; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid; " width=123>
1일 2휘
1회 500mg</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 106.3pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #fbd4b4; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid; " width=142>
1일 2휘
1회 250mg</TD></TR>
<TR style="mso-yfti-irow: 5; mso-yfti-lastrow: yes">
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 3cm; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid; " width=113>
Metronidazole</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 114.85pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #fbd4b4; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid; " width=153>
 </TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 77.95pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #fbd4b4; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid; " width=104>
 </TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 92.15pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #fbd4b4; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid; " width=123>
1일 2휘
1회 400mg</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 106.3pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #fbd4b4; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid; " width=142>
1일 2휘
1회 400mg</TD></TR></TBODY></TABLE>
이상의 처방으로 6-8주사이에도 양성인 자는 
비스므스 함유 4종 약을 14일간 추가 치료 함</TD></TR></TBODY></TABLE>
 
 
 <IMG src="/_dimg/4-4%2020150217_205822.png">
 [그림] 헬리코 균의 발암 독성 (CagA)
 
 
젊은이 일수록 음성율 낮다 
 
Helicobacter pylori 균은 감염된 상태에서 오랜 기간을 통해
 암을 유발하므로 젊었을 때부터 일찍 제균하는 것이 중요하다
 
그러나 아래 표에서 처럼 
 젊은 이들의 음성 율이 가장 낮다는 사싫이 밝혀 진것이다
 
 
<TABLE style="WIDTH: 487.35pt; BORDER-COLLAPSE: collapse; mso-yfti-tbllook: 1184; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt" Table border=0 cellSpacing=0 cellPadding=0 width=650>
<TBODY>
<TR style="mso-yfti-irow: 0; mso-yfti-firstrow: yes">
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 487.35pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ccffff; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: windowtext 1pt solid; " width=650 colSpan=3>
나이 별로  본  1년 후 음성 자  (약효)</TD></TR>
<TR >
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 104.65pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ff99ff; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=140>
 </TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 191.35pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ff99ff; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=255>
음성 자</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 191.35pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ff99ff; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=255>
음성 율</TD></TR>
<TR >
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 104.65pt; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=140>
21-29세</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 191.35pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ddd9c3; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; mso-background-themecolor: background2; mso-background-themeshade: 230" width=255>
235명중 183명</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 191.35pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #66ff66; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=255>
70.5%</TD></TR>
<TR >
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 104.65pt; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=140>
30-39세</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 191.35pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ddd9c3; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; mso-background-themecolor: background2; mso-background-themeshade: 230" width=255>
392명중 268명</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 191.35pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #66ff66; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=255>
68.4</TD></TR>
<TR >
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 104.65pt; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=140>
40-49세</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 191.35pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ddd9c3; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; mso-background-themecolor: background2; mso-background-themeshade: 230" width=255>
344명중 252명</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 191.35pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #66ff66; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=255>
73.3</TD></TR>
<TR >
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 104.65pt; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=140>
50세이상</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 191.35pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ddd9c3; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; mso-background-themecolor: background2; mso-background-themeshade: 230" width=255>
384명중 295명</TD>
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ece9d8; PADDING-LEFT: 5.4pt; WIDTH: 191.35pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #66ff66; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=255>
76.8%</TD></TR>
<TR style="mso-yfti-irow: 6; mso-yfti-lastrow: yes">
<TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 487.35pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #f2f2f2; BORDER-TOP: #ece9d8; BORDER-RIGHT: windowtext 1pt solid; " width=650 colSpan=3>
나이별 분석 이유: Helico 균 제균 목적 중 하나인 위장 암 예방은 
젊은 때부터 제균 해야하기 때문이다 </TD></TR></TBODY></TABLE>
 
 
[근거]
JAMA, February 13, 2013—Vol 309, No. 309(6):578-586
Risk of Recurrent Helicobacter pylori Infection 1 Year After Initial Eradication Therapy in 7 Latin American Communities;
Douglas R. Morgan, MD, MPH Javier Torres, PhD Rachael Sexton, MS Rolando Herrero, MD, PhD Eduardo Salazar-Martı´nez, MD E. Robert Greenberg, MD Luis Eduardo Bravo, MD Ricardo L. Dominguez, MD Catterina Ferreccio, MD, MPH Eduardo C. Lazcano-Ponce, MD, PhD Maria Mercedes Meza-Montenegro, PhD Edgar M. Pen˜ a, MD, MPH Rodolfo Pen˜ a, MD, DrPH Pelayo Correa, MD Marı´a Elena Martı´nez, PhD William D. Chey, MD
Manuel Valdivieso, MD Garnet L. Anderson, PhD  Gary E. Goodman, MD, MS John J. Crowley, PhD Laurence H. Baker, DO
Author Affiliations: 
Division of Gastroenterology,Hepatology, & Nutrition, Department of Medicine,Vanderbilt Medical Center, Nashville, Tennessee 
; Division of Gastroenterology,University of North Carolina, 
Unidad de Investigacio´n en Enfermedades Infecciosas,
Instituto Mexicano del Seguro Social, MexicoCity, Mexico 
Cancer Research And Biostatistics, Seattle, Washington
International Agency for Research on Cancer,Lyon, France, and Fundacio´n INCIENSA, San Jose´Costa Rica
; Instituto Nacional de SaludPu´blica, Cuernavaca, Mexico 
; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle,Washington 
Departamento de Patologı´a, Universidad del Valle, Cali, Colombia
Hospital Regional de Occidente,Santa Rosa de Copa´n, Honduras ; Departamento de Salud Pu<SPAN