溃疡分期对幽门螺杆菌根除率的影响

Influence of Ulcer Stage on Helicobacter pylori Eradication Rate

背景:幽门螺杆菌(Hp)感染与多种胃肠道疾病的发生相关。研究表明,Hp根除率可能受疾病种类、疾病进展阶段的影响。目的:探讨内镜下溃疡分期对Hp根除率的影响。方法:收集2015年1月—2016年7月新疆维吾尔自治区人民医院收治的Hp感染消化性溃疡(PU)患者423例,其中胃溃疡(GU)组133例,十二指肠溃疡(DU)组255例,予14 d含铋剂四联疗法根除Hp治疗。比较不同内镜分期溃疡患者Hp根除率的差异,对Hp根除率影响因素进行单因素分析。结果:GU与DU组间Hp根除率差异无统计学意义(82.7%对83.9%,P>0.05)。GU组活动期溃疡患者根除率显著高于非活动期(89.0%对75.0%,P<0.05),而DU组两亚组间根除率无明显差异(85.6%对83.0%,P>0.05)。单因素分析显示,溃疡分期与是否能成功根除Hp相关,活动期PU患者根除率显著高于非活动期(87.8%对80.3%,P<0.05)。结论:内镜下溃疡分期与PU尤其是GU患者的Hp根除率有关,在溃疡活动期进行Hp根除治疗能显著提高根除率。

Helicobacter pylori （Hp） infection is associated with a variety of gastrointestinal diseases. Studies have shown that Hp eradication rate may be affected by the disease type and stage of disease progression. Aims ： To investigate the influence of endoscopic ulcer stage on Hp eradication rate. Methods： A total of 423 peptic ulcer （PU） patients with Hp infection from January 2015 to July 2016 at the People＇ s Hospital of Xinjiang Uygur Autonomous Region were enrolled. Of them, 133 were gastric ulcer （GU） and 255 were duodenal ulcer （DU）. A 14-day bismuth quadruple therapy was given for Hp eradication, and the eradication rates were analyzed with the endoscopic ulcer stage. Univariate analysis was conducted to identify factors influencing the eradication rate. Results： There was no significant difference in Hp eradication rates between GU and DU groups （82.7% vs. 83.9%, P 〉 0.05）. The eradication rates according to endoscopic ulcer stage were significantly different in GU group （ active stage vs. inactive stage ： 89.0% vs. 75.0%, P 〈 0.05 ） ; but in DU group, the eradication rate in active stage was similar to that in inactive stage （85.6% vs. 83.0%, P 〉 0.05 ）. Univariate analysis revealed that ulcer stage was correlated with the success rate of eradication ; the eradication rate in active stage was significantly higher than that in inactive stage （87.8% vs. 80.3%, P 〈0.05）. Conclusions： Endoscopic ulcer stage is correlated with the Hp eradication rate in PU, especially GU patients. Hp eradication therapy performed in patients with active PU could yield a higher eradication rate.