Leung Wai-Keung, Hung Lawrence Cheung-Tsui, Kwok Carrie Ka-Li, Leong Rupert Wing-Loong, Ng Daniel Kwok-Keung, Sung Joseph Jao-Yiu
Department of Medicine Therapeutics, Prince of Wales Hospital, Shatin, N.T., Hong Kong, China.
World J Gastroenterol. 2002 Aug;8(4):703-6. doi: 10.3748/wjg.v8.i4.703.
The widespread use of antibacterial therapy has been suggested to be the cause for the decline in the prevalence of Helicobacter pylori infection. This study examine the serial changes of urea breath test results in a group of hospitalized patients who were given antibacterial therapy for non-gastric infections.
Thirty-five hospitalized patients who were given antibacterial therapy for clinical infections, predominantly chest and urinary infections, were studied. Most (91 %) patients were given single antibiotic of either a penicillin or cephalosporin group. Serial (13)C-urea breath tests were performed within 24 hours of initiation of antibiotics, at one-week and at six-week post-therapy. H. pylori infection was diagnosed when one or more urea breath tests was positive.
All 35 patients completed three serial urea breath tests and 26 (74 %) were H. pylori-positive. Ten (38 %) H. pylori-infected patients had at least one negative breath test results during the study period. The medium delta (13)C values were significantly lower at baseline (8.8) than at one-week (20.3) and six-week (24.5) post-treatment in H. pylori-positive individuals (P=0.022). Clearance of H. pylori at six-week was only seen in one patient who had received anti-helicobacter therapy from another source.
Our results suggested that one-third of H. pylori-infected individuals had transient false-negative urea breath test results during treatment with antibacterial agent. However, clearance of H. pylori infection by regular antibiotic consumption is rare.
有人认为抗菌治疗的广泛使用是幽门螺杆菌感染率下降的原因。本研究调查了一组因非胃部感染接受抗菌治疗的住院患者尿素呼气试验结果的系列变化。
研究了35名因临床感染(主要是胸部和泌尿系统感染)接受抗菌治疗的住院患者。大多数(91%)患者使用了青霉素类或头孢菌素类单一抗生素。在开始使用抗生素后24小时内、治疗后1周和6周进行系列¹³C尿素呼气试验。一次或多次尿素呼气试验呈阳性则诊断为幽门螺杆菌感染。
所有35名患者均完成了三次系列尿素呼气试验,26名(74%)为幽门螺杆菌阳性。10名(38%)幽门螺杆菌感染患者在研究期间至少有一次呼气试验结果为阴性。幽门螺杆菌阳性个体的基线平均δ¹³C值(8.8)显著低于治疗后1周(20.3)和6周(24.5)(P = 0.022)。仅1名从其他来源接受过抗幽门螺杆菌治疗的患者在6周时出现幽门螺杆菌清除。
我们的结果表明,三分之一的幽门螺杆菌感染个体在接受抗菌药物治疗期间尿素呼气试验出现短暂假阴性结果。然而,通过常规使用抗生素清除幽门螺杆菌感染的情况很少见。