中华消化杂志
中華消化雜誌
중화소화잡지
Chinese Journal of Digestion
2009年
6期
361-364
,共4页
孟灵梅%周丽雅%林三仁%闫秀娥%丁士刚%黄永辉%顾芳%张莉%李渊%崔荣丽%张冬红%张静
孟靈梅%週麗雅%林三仁%閆秀娥%丁士剛%黃永輝%顧芳%張莉%李淵%崔榮麗%張鼕紅%張靜
맹령매%주려아%림삼인%염수아%정사강%황영휘%고방%장리%리연%최영려%장동홍%장정
消化性溃疡%复发%幽门螺杆菌%随访研究
消化性潰瘍%複髮%幽門螺桿菌%隨訪研究
소화성궤양%복발%유문라간균%수방연구
Peptic ulcer%Recurrence%Helicobacterpylori%Follow-up studies
目的 探讨根除幽门螺杆菌(Helicobacter pylori,Hp)后10年间十二指肠球部溃疡(DU)、胃溃疡(GU)发病情况.方法 选择胃癌高发区山东烟台高陵镇随机抽样自然人群进行内镜普查,其中Hp阳性者552例均分为治疗组和安慰剂组,治疗组276例予以奥美拉唑20 mg、克拉霉素0.5 g和阿莫西林1.0 g,每日2次口服,疗程7 d.停药1个月后治疗组行13C-尿素呼气试验(13C-UBT)证实根除成功.此后对两组在10年期间进行内镜随访(第1、5、8和10年),观察两组患者消化性溃疡发病率的变化及复发情况,同时观察两组Hp感染状态的变迁.结果 治疗组消化性溃疡第1、5和8年的发病率分别为3.70%、5.86%和4.40%,均明显低于安慰剂组(12.85%、14.93%和9.39%,P值分别=0.0002、0.0017和0.0440).随访10年间,治疗组消化性溃疡新发病例数及复发病例数均低于安慰剂组,两组间差异均有统计学意义(P值均<0.05).治疗组Hp再感染率较高,第10年时Hp阳性率达46.4%.根据Hp感染状态重新进行分组,结果显示随访10年间Hp阴性组消化性溃疡的发病率均低于Hp阳性组(P值均<0.05).结论 根除Hp治疗后消化性溃疡的发病率和复发率均明显降低,消化性溃疡患者根除Hp是必要的.成功根除Hp后再感染率仍较高.
目的 探討根除幽門螺桿菌(Helicobacter pylori,Hp)後10年間十二指腸毬部潰瘍(DU)、胃潰瘍(GU)髮病情況.方法 選擇胃癌高髮區山東煙檯高陵鎮隨機抽樣自然人群進行內鏡普查,其中Hp暘性者552例均分為治療組和安慰劑組,治療組276例予以奧美拉唑20 mg、剋拉黴素0.5 g和阿莫西林1.0 g,每日2次口服,療程7 d.停藥1箇月後治療組行13C-尿素呼氣試驗(13C-UBT)證實根除成功.此後對兩組在10年期間進行內鏡隨訪(第1、5、8和10年),觀察兩組患者消化性潰瘍髮病率的變化及複髮情況,同時觀察兩組Hp感染狀態的變遷.結果 治療組消化性潰瘍第1、5和8年的髮病率分彆為3.70%、5.86%和4.40%,均明顯低于安慰劑組(12.85%、14.93%和9.39%,P值分彆=0.0002、0.0017和0.0440).隨訪10年間,治療組消化性潰瘍新髮病例數及複髮病例數均低于安慰劑組,兩組間差異均有統計學意義(P值均<0.05).治療組Hp再感染率較高,第10年時Hp暘性率達46.4%.根據Hp感染狀態重新進行分組,結果顯示隨訪10年間Hp陰性組消化性潰瘍的髮病率均低于Hp暘性組(P值均<0.05).結論 根除Hp治療後消化性潰瘍的髮病率和複髮率均明顯降低,消化性潰瘍患者根除Hp是必要的.成功根除Hp後再感染率仍較高.
목적 탐토근제유문라간균(Helicobacter pylori,Hp)후10년간십이지장구부궤양(DU)、위궤양(GU)발병정황.방법 선택위암고발구산동연태고릉진수궤추양자연인군진행내경보사,기중Hp양성자552례균분위치료조화안위제조,치료조276례여이오미랍서20 mg、극랍매소0.5 g화아막서림1.0 g,매일2차구복,료정7 d.정약1개월후치료조행13C-뇨소호기시험(13C-UBT)증실근제성공.차후대량조재10년기간진행내경수방(제1、5、8화10년),관찰량조환자소화성궤양발병솔적변화급복발정황,동시관찰량조Hp감염상태적변천.결과 치료조소화성궤양제1、5화8년적발병솔분별위3.70%、5.86%화4.40%,균명현저우안위제조(12.85%、14.93%화9.39%,P치분별=0.0002、0.0017화0.0440).수방10년간,치료조소화성궤양신발병례수급복발병례수균저우안위제조,량조간차이균유통계학의의(P치균<0.05).치료조Hp재감염솔교고,제10년시Hp양성솔체46.4%.근거Hp감염상태중신진행분조,결과현시수방10년간Hp음성조소화성궤양적발병솔균저우Hp양성조(P치균<0.05).결론 근제Hp치료후소화성궤양적발병솔화복발솔균명현강저,소화성궤양환자근제Hp시필요적.성공근제Hp후재감염솔잉교고.
Objective To investigate the incidence of peptic ulcer (duodenal ulcer and gastric ulcer) and the development of Helicobacter pylori (Hp) infection in the population during 10 years after Hp eradication.Methods Subjects were chosen from general population and performed endoscopy.Among them,the individuals confirmed to be Hp positive were randomly divided into treatment group and placebo group.The patients in treatment group received OAC triple therapy (omeprazole 20 mg,clarithromycin 500 nag and amoxicillin 1000 re.g,twice daily) for one week.After that,both groups continuously followed up by endoscopy during at 1st,5th,8th and 10th year for incidence and relapse of peptic ulcer as well as status of Hp infection.The patients in treatment group were examined by 13C-UBT for Hp eradication one month after the completion of treatment.Results At the 1st year,the incidence of peptic ulcer between the treatment group and placebo group were 3.7% and 12.85% (P=0.0002),respectively.At the 5th year,they were 5.86% and 14.93% (P=0.0017),respectively.At the 8th year,they were 4.4% and 9.39% (P = 0.044),respectively.The incidence of peptic ulcer of the treatment group significantly decreased after the eradication therapy compared to the placebo group.After the eradication,at the 1st year,the recurrence rates were 3.70% and 38.1% between the treatment group and the placebo group (P=0.0027).At the 5th year,they were 14.81% and 42.86% (P=0.03).At 8th year,they were 14.81 and 47.62% (P=0.03),respectively.At the 10th year,they were 25.93% and 57.14% (P=0.028).Then the recurrence rates of the treatment group significantly decreased compared to the placebo group.During the 10-year follow up study,the rate of Hp reinfection after a successful eradication in the treatment group was high,and it was 46.4% at the 10th year.Conclusion Both the incidence and recurrence of peptic ulcer significantly decreased after Hp eradication.It is necessary of Hp eradication in patients with peptic ulcer.Hp reinfection after a successful eradication is more frequent.
