根除幽门螺杆菌对胃增生性息肉的作用

Therapeutic effects of eradicating Helicobacter pylori on gastric hyperplastic polyps

目的探讨根除幽门螺杆菌(Hp)对胃增生性息肉的作用.方法将胃增生性息肉(息肉直径3～10 mm)合并Hp感染的48例患者随机分为治疗组及对照组(各24例).治疗组患者接受四联治疗,包括质子泵抑制剂(奥美拉唑或兰索拉唑)、克拉霉素、枸橼酸铋及替硝唑,疗程2周.对照组仅接受替普瑞酮治疗.受试者在纳入试验前及治疗结束后1～12个月接受定期胃镜检查和Hp测定.结果治疗组和对照组各有22例及21例患者完成整个研究.治疗组有19例(86.4%)Hp得到根除,在用药后1～12个月,平均(6.5±1.1)个月随访中,Hp根除者中15例(78.9)胃息肉消失.而在试验开始后12个月,对照组患者的胃息肉和Hp情况未发生变化(P＜0.01).结论大多数胃增生性息肉在根除Hp后消失,患者如同时患有胃增生性息肉和Hp感染,在行息肉摘除术前可先尝试Hp根除治疗.

Objective To study the therapeutic effects of eradicating Helicobacter pylori (H.pylori) on the gastric hyperplastic polyps. Methods Forty-eight patients with H. pylori infection and gastric hyperplastic polyps (3-10 mm in diameter) were randomly assigned to a treatment group (n=24) receiving a quadruple therapy of proton-pump inhibitor (omeprazole or lansoprazole), clarithromycin, bismuth citrate and tinidazole, or to a control group (n=24) which receiving tepretone (a gastric mucosa protective agent). Patients underwent endoscopy and H.pylori examination regularly before enrollment and 1 to 12 months after the end of treatment. Results Twenty-two patients in the treatment group and 21 in controls completed the entire trial. In the treatment group, H. pylori was eradicated in 19 of 22 patients (86.4%) and the polyps had disappeared in 15 of all 19 patients (78.9%) during 1 to 12 months follow-up period, average (6.5±1.1)months, after the end of treatment. However, no change was seen in the polyps and H. pylori status in the controls during same period (P<0.01). Conclusions Most of gastric hyperplastic polyps disappeared after the eradication of H. pylori. Thus, before endoscopic removal of polyps in patients with H.pylori infection, the eradication of H.pylori might be tried.