幽门螺杆菌根除治疗后再感染的危险因素分析

Risk Factors of Helicobacter pylori Re-infection After Eradication

背景:幽门螺杆菌(Hp)为世界上流行较为广泛的慢性致病菌之一,根除治疗后极易复发。目的:探讨Hp感染者接受根除治疗后再感染的危险因素。方法:本研究为前瞻性队列研究,选取2012年1月—2014年1月于解放军空军第九八六医院行^(14)C-尿素呼气试验确诊为Hp感染的803例患者。所有患者成功根除Hp后随访3年,记录随访期内Hp再感染情况。以单因素分析以及多元Logistic回归模型分析Hp再感染的危险因素。结果:共721例患者完成随访,Hp再感染率为8.7%。单因素和多元Logistic回归分析显示,年龄、消化性溃疡、牙周炎以及长期使用抗菌药物为Hp再感染的独立危险因素,发酵乳制品、水果、蔬菜摄入为预防Hp再感染的保护性因素。结论:根除Hp后仍具有再感染的风险,临床治疗时应积极控制其危险因素,从而降低Hp的再感染风险。

Background: Helicobacter pylori (Hp) is one of the most prevalent chronic pathogens in the world. It is easily to recur after eradication treatment. Aims: To investigate the risk factors of Hp re-infection after eradication. Methods: A prospective cohort study was performed from January 2012 and January 2014 at Hospital of 75600 PLA Troops with 803 patients of Hp infection diagnosed by 14 C-urea breath test. All patients were followed up for 3 years after successful eradication of Hp infection. Hp re-infection was recorded during the follow-up. The risk factors of Hp re-infection were analyzed by univariate and multivariate Logistic regression analysis. Results: A total of 721 patients finished the 3 year follow-up. Hp re-infection rate was 8.7%. Univariate and multivariate Logistic regression analysis showed that age, peptic ulcer, periodontitis, and long-term use of antibiotics were independent risk factors of Hp re-infection, and fermented dairy products, fruits and vegetables were protective factors for Hp re-infection. Conclusions: After Hp eradication, there still has the risk of re-infection, risk factors should be positively controlled in clinic, thereby reducing the risk of Hp re-infection.