Vaira D, Vakil N, Rugge M, Gatta L, Ricci C, Menegatti M, Leandro G, Holton J, Russo V M, Miglioli M
Department of Internal Medicine and Gastroenterology, University of Bologna, Bologna, Italy.
Gut. 2003 Nov;52(11):1543-7. doi: 10.1136/gut.52.11.1543.
There are few data on the course of Helicobacter pylori infection in asymptomatic subjects. The aim of this study was to assess the effect of eradication therapy on the development of dyspeptic and gastro-oesophageal reflux disease in a cohort of asymptomatic individuals observed over a prolonged period.
A total of 169 blood donors infected with H pylori who had volunteered for studies on eradication in 1990 formed the cohort. To be included in this cohort subjects had to have no symptoms, as determined by a validated symptom questionnaire at the baseline visit. Eighty eight subjects were infected with H pylori while 81 had successfully undergone eradication therapy. Subjects were followed up (annually) using the same symptom questionnaire and in 2000 they underwent repeat endoscopy.
Thirteen subjects developed symptoms during follow up. The incidence of symptoms in H pylori positive subjects was 1.893/100 person-years of follow up and in H pylori negative individuals 0.163/100 person-years of follow up. H pylori infected subjects were significantly more likely to develop symptoms (log rank test, p=0.003) as well as those infected with CagA positive strains (log rank test, p=0.017). The development of symptomatic gastro-oesophageal reflux disease was no different in individuals with and without eradication (odds ratio 0.57 (95% confidence interval 0.26-1.24); p=0.163).
H pylori eradication prevents the development of dyspeptic symptoms and peptic ulcer disease in healthy asymptomatic blood donors and is not associated with an increase in the incidence of symptomatic gastro-oesophageal reflux disease.
关于无症状人群幽门螺杆菌感染病程的数据较少。本研究旨在评估根除治疗对一组长期观察的无症状个体中消化不良和胃食管反流病发生发展的影响。
1990年自愿参与根除研究的169名感染幽门螺杆菌的献血者组成了该队列。要纳入该队列，受试者在基线访视时必须通过有效的症状问卷确定无症状。88名受试者感染幽门螺杆菌，81名成功接受了根除治疗。使用相同的症状问卷对受试者进行随访（每年一次），并在2000年对他们进行重复内镜检查。
13名受试者在随访期间出现症状。幽门螺杆菌阳性受试者的症状发生率为1.893/100人年随访，幽门螺杆菌阴性个体为0.163/100人年随访。幽门螺杆菌感染的受试者出现症状的可能性显著更高（对数秩检验，p = 0.003），感染CagA阳性菌株的受试者也是如此（对数秩检验，p = 0.017）。有或没有根除治疗的个体中，有症状的胃食管反流病的发生情况没有差异（优势比0.57（95%置信区间0.26 - 1.24）；p = 0.163）。
根除幽门螺杆菌可预防健康无症状献血者中消化不良症状和消化性溃疡病的发生，且与有症状的胃食管反流病发病率增加无关。
