Bapat M R, Abraham P, Bhandarkar P V, Phadke A Y, Joshi A S
Department of Gastroenterology, K E M Hospital, Mumbai.
Indian J Gastroenterol. 2000 Oct-Dec;19(4):172-4.
Eradication of Helicobacter pylori infection is known to decrease the recurrence rate of peptic ulcer disease. Data from India on the acquisition rate of H. pylori infection and reinfection after eradication are scant.
To study the rates of acquisition of H. pylori infection and of reinfection after eradication in Indian adult patients.
We evaluated 116 consecutive patients with dyspepsia undergoing endoscopy. Sixty-four of them were H. pylori-positive on gastric antral biopsy (rapid urease test and histology). Patients diagnosed to have H. pylori infection were treated with a four-drug regimen (omeprazole, bismuth subcitrate, tetracycline, furazolidine) for 2 weeks; those failing H. pylori eradication were treated with a second regimen (lansoprazole, amoxycillin, secnidazole) for one week. Patients who were H. pylori-negative to begin with and those who had successful H. pylori eradication were followed up clinically and endoscopically every 3 months for a median of one year.
Ninety-six patients (50 H. pylori-positive) were available for study; the other 20 were lost to follow up after the first endoscopy. Fifty of the 96 (52%) were H. pylori-positive; four of these 50 patients did not follow up after first treatment. The eradication rate with the four-drug regimen was 89.1% (41/46). Four of the 5 non-responders eradicated H. pylori with the second regimen. At the end of median one year follow-up (range 9-15 months), one of the 45 patients (2.4%) who eradicated the organism developed reinfection; none of the 46 patients who were initially H. pylori-negative acquired new infection.
The risk of reinfection after eradication is low in Indian subjects at the end of one year. The rate of acquisition of new infection is also low in the adult population.
已知根除幽门螺杆菌感染可降低消化性溃疡疾病的复发率。印度关于幽门螺杆菌感染获得率及根除后再感染的数据很少。
研究印度成年患者中幽门螺杆菌感染的获得率及根除后的再感染率。
我们评估了116例连续接受内镜检查的消化不良患者。其中64例胃窦活检（快速尿素酶试验和组织学检查）显示幽门螺杆菌阳性。诊断为幽门螺杆菌感染的患者接受为期2周的四联疗法（奥美拉唑、枸橼酸铋钾、四环素、呋喃唑酮）治疗；幽门螺杆菌根除失败的患者接受为期1周的二线疗法（兰索拉唑、阿莫西林、塞克硝唑）治疗。最初幽门螺杆菌阴性的患者以及幽门螺杆菌根除成功的患者每3个月进行一次临床和内镜随访，中位随访时间为1年。
96例患者（50例幽门螺杆菌阳性）可供研究；另外20例在首次内镜检查后失访。96例患者中有50例（52%）幽门螺杆菌阳性；这50例患者中有4例在首次治疗后未进行随访。四联疗法的根除率为89.1%（41/46）。5例未应答者中有4例通过二线疗法根除了幽门螺杆菌。在中位1年随访结束时（范围9 - 15个月），45例根除幽门螺杆菌的患者中有1例（2.4%）发生了再感染；46例最初幽门螺杆菌阴性的患者均未获得新感染。
在印度人群中，根除幽门螺杆菌1年后再感染风险较低。成年人群中新感染的获得率也较低。
