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幽门螺杆菌根除后再感染与溃疡复发 被引量:39

Helicobacter pylori- reinfection and ulcer recurrence in patients with duodenal ulcer healing: a 2-year following-up in an area with high prevalence of helicobacter pylori
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摘要 目的明确广州地区十二指肠溃疡患者幽门螺杆菌(Hp)根除后再感染和溃疡复发情况。方法以14C-尿素呼气试验和胃镜检查(尿素酶、组织学及细菌培养),对十二指肠溃疡患者Hp根除后共184例进行2年定期随访,并配合随机引物扩增的DNA多态指模技术鉴定Hp菌株复发与再感染。结果Hp根除后第1、2年再感染率分别为1.10%和0.56%;溃疡复发率分别为2.72%和0.56%;全部病例未发生溃疡出血,而同期Hp未根除的对照组2年溃疡累积再出血率为26.9%(P<0.005)。结论成人患者Hp根除后对Hp再感染不易感,而且发展中国家Hp根除后再感染率也相当低,以预防溃疡复发为目的的Hp根除疗法同样适用于高Hp感染率地区。 Objective To determine Helicobacter pylori- (Hp) reinfection and ulcer recurrence following Hp eradication in an area with high prevalence of Hp. Methods 184 cases with endoscopy confirmed Hp eradication and ulcer healing as well as and negative 14 C urea breath test three months after cessation of treatment for 2 years were followed. 14 C urea breath test was performed at the 6th, 12th, 18th, and 24th month after the ending of treatment, and endoscopy (including urease test, histology and culture for Hp) performed at the 12th and 24th month or whenever breath test was positive or ulcer symptom recurred. Recurrence of Hp was discriminated as recrudescence or reinfection by means of a randomly amplified polymorphic DNA fingerprinting by comparison of the isolates obtained from recurrence and pretreatment. Results The 1st and 2nd year reinfection rates were 1.10% and 0 56% respectively; ulcer recurrence rates 2.72% and 0.56% respectively; ulcer rebleeding did not occur in any of the follow up cases, as compared with 26.9% of two year cumulated ulcer rebleeding rate in a Hp positive control group ( P <0.005). Conclusion The results of this study suggest that adult patients are not susceptible to Hp reinfection, reinfection rate is very low in developing country as in Western developed countries and thus Hp eradication therapy aimed at prevention of ulcer recurrence is also worthwhile in an area with high Hp prevalence.
出处 《中华内科杂志》 CAS CSCD 北大核心 1998年第1期17-20,共4页 Chinese Journal of Internal Medicine
基金 卫生部 广东省科委基金 教委博士点基金
关键词 螺杆菌 幽门 十二指肠溃疡 复发 病因 Helicobacter pylori Duodenal ulcer Recurrence
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参考文献5

  • 1Xia H X,Gut,1995年,37卷,30页
  • 2胡品津,临床消化病杂志,1995年,7期,111页
  • 3胡品津,中华内科杂志,1995年,34卷,819页
  • 4李瑜元,中华医学杂志,1993年,73卷,168页
  • 5陈--湖,临床胃肠病学,1981年,97页

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