Resumen
El frecuente uso de terapias antibióticas para erradicar el Helicobacter pylori (Hp) en pacientes con úlcera duodenal (UD) hace necesario contar con sistemas para confirmar el éxito terapéutico. En este estudio se diseñó y aplicó ELISA a fin de evaluar la erradicación de Hp después del tratamiento antibiótico. Para ello se monitorearon los títulos de anticuerpos IgG contra Hp en 107 pacientes con UD. Del total, 61 recibieron amoxicilina, metronidazol, subsalicilato de bismuto y omeprazol, y 46 sólo omeprazol. Luego del tratamiento, 49 pacientes bajo terapia antibiótica lograron erradicar el Hp y 58 persistieron colonizados (12 en quienes la terapia antibiótica fracasó y todos los tratados con omeprazol). De acuerdo con los resultados, los pacientes que alcanzaron la erradicación del Hp exhibieron una caída sostenida de los títulos de anticuerpos; y en aquellos que no lograron erradicar el organismo, la caída de los títulos fue significativamente menor, incluso registrándose incrementos en algunos casos. En conclusión, la serología cuantitativa para Hp resultó ser una herramienta útil para monitorear el éxito de una terapia antibiótica en pacientes con UD. La reducción del 45% de los niveles de anticuerpos al 4to. mes postratamiento se correlacionó con el éxito terapéutico.
Palabras clave
Helicobacter pylori, úlcera duodenal, ELISA, anticuerpos, terapia antibiótica
Clasificación en siicsalud
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Especialidades
Principal: Gastroenterología
Relacionadas: Medicina Interna, Epidemiología, Farmacología, Diagnóstico por Laboratorio
Artículo completo
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Abstract
To assess the effectiveness of the increasing use of antibiotic therapy to treat Helicobacter pylori (Hp) in duodenal ulcer (DU) patients or other gastric pathologies the clinician should have diagnostic tools able to determine treatment success or failures. In the present study an ELISA was applied to evaluate the eradication status after antibiotic treatment. The levels of IgG antibodies to Hp were determined in 107 DU patients, from these, 61 received quadruple therapy, amoxicillin, metronidazole, bismuth-subsalicylate plus omeprazole and 46 a monotherapy with omeprazole. After the antibiotic treatment 49 patients eradicated Hp and 58 persisted colonized, 12 in whom antibiotic therapy failed and 46 that received omeprazole alone. The serologic follow-up revealed that patients that eradicated Hp maintained a consistent drop in serum antibody titters. DU patients who failed to eradicate Hp had a discrete antibody titter reduction, moreover, in some of them their antibody titters increased. In conclusion, the quantitative serology for Hp was useful to confirm therapy success in patients with DU. The follow up study revealed that if by month four the antibody drop was 45% or more the treatment would be considered a success.
Key words
Helicobacter pylori, duodenal ulcer, ELISA, antibodies
Bibliografía del artículo
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