围绝经期对女性幽门螺杆菌杀菌治疗效果的影响

The impact of perimenopause on the bactericidal and therapeutic effects of Helicobacter pylori in women

目的 探讨围绝经期对幽门螺杆菌(HP)感染女性治疗效果的影响。方法 选取2019年9月-2020年10月杭州市临平区第一人民医院收治的感染HP的围绝经期女性51例为观察组,同期在该院治疗的49例感染HP的非围绝经期女性为对照组,回顾性分析两组研究对象临床资料。两组患者均使用四联疗法进行杀菌治疗,对比两组患者治疗前后HP水平的差异;将观察组中疗效不佳的病例纳入不良组共15例,剩余36例疗效良好的病例纳入良好组,采用单因素、多因素分析影响围绝经期HP感染女性疗效不佳的危险因素;采用Pearson相关系数分析以上危险因素与HP程度的相关性。结果 采用同种四联疗法治疗后,对照组女性体内HP水平[(51.22±25.87)dpm]显著低于观察组[(197.06±35.95)dpm],差异有统计学意义(t=3.682,P<0.05)。多因素分析结果显示,BMI≥28.00 kg/m^(2)是影响围绝经期HP感染女性疗效不佳的危险因素(OR=1.273,95%CI为0.342~4.001,P<0.05)。Pearson相关系数显示,BMI与HP程度呈显著正相关关系(r=0.300,P<0.05)。结论 围绝经期会导致HP感染女性疗效下降,且BMI作为影响HP感染女性疗效不佳的危险因素,在治疗过程中密切关注其变化能够改善围绝经期HP感染女性的预后。

Objective To explore the effects ofperimenopause on the therapeutic efficacy of Helicobacter pylori(HP) infection in women.Methods A total of 51 perimenopausal womeninfected with HP who wereadmitted to Hangzhou Linping District First People’s Hospital from September 2019 to October 2020 were selected as observation groupand49 non-perimenopausal women infected with HP who were treated in this hospital during the same periodwere selected as control group.Retrospective analysis of clinical data of the two groups was performed.Both groups received quadruple therapyfor bactericidal treatment.HP levels were compared between the two groups before and after treatment.A total of 15 cases with poor curative effect in the observation group wereselected as poor prognosis group and the remaining 36 cases with good curative effectwere selected as good prognosis group.Univariate and multivariate analysiswas used to identify risk factors for poor therapeutic efficacy in perimenopausal women infected with HP.The Pearson correlation coefficient was used toanalyze the correlation between the above risk factors and HP infection degree.Results Following treatment with the same quadruple therapy, HP levels in women in the control group [(51.22±25.87) dpm]were significantly lower than those in the observation group [(197.06±35.95) dpm], with statistical significance(t=3.682, P<0.05).Multivariate analysis showed that BMI≥28.00 kg/m^(2) was a risk factor for poor therapeutic efficacy in perimenopausal women infected with HP(OR=1.273, 95% CI=0.342-4.001, P<0.05).The Pearson correlation coefficient showed that there was a significant positive correlation between BMI and HP infection degree(r=0.300, P<0.05).Conclusion Perimenopause might lead to reduced therapeutic efficacy in women infected with HP.Also, close attention to thealternationsof BMI during treatment might improve the prognosis of perimenopausal women infected with HPas itwas a risk factor for poor outcomes in women infected with HP.