Bermejo F, Boixeda D, Martín De Argila C, López San Román A, Defarges V, Hernández Ranz H, Vázquez M, García Plaza A
Servicio de Gastroenterología. Hospital Ramón y Cajal. Universidad de Alcalá. Madrid. Spain.
Rev Esp Enferm Dig. 2003 Sep;95(9):625-8, 621-4.
some authors suggest that Helicobacter pylori eradication favors gastric ulcer healing.
to study which factors influence ulcer healing in patients suffering from gastric ulcer with H. pylori infection.
a prospective study of 230 patients with gastric ulcer associated to H. pylori infection. Chronic ingestion of non-steroidal anti-inflammatory drugs was considered as an exclusion. In an initial endoscopy, malignancy was histologically excluded and two biopsies each of antrum and body were obtained. Also, ELISA IgG serology and a 13C-urea breath test were performed. Eradication therapy with omeprazole (20 mg twice a day), clarithromycin (500 mg twice a day) and amoxicillin (1 g twice a day) was administered for seven days, followed by omeprazole 20 mg once a day for five more weeks. Endoscopy was repeated after 6 weeks of treatment and breath test was repeated 2 month after completing therapy.
overall gastric ulcer healing was achieved in 80.8% (95% CI: 75-85%) of cases by intention-to-treat, and in 82.6% (77-87%) per protocol. Ulcer healing was achieved in 94.3% (90-97%) of patients with eradication success, but only in 40.8% (28-54%) of patients with eradication failure (p<0.0001). In the multivariate analysis, H. pylori eradication was the only variable that correlated with ulcer healing (odds ratio 24; 95% CI: 10-56; p<0.0001) (x2 model: 64.4; p<0.0001). Additional variables (age, sex, sporadic ingestion of NSAIDs, smoking, previous ulcer disease, ulcer size and location) were not related to healing.
H. pylori eradication favors ulcer healing in patients with gastric ulcer, which is an argument in favor of the etiological role of the microorganism in this disease. Other factors did not influence ulcer healing.
一些作者认为根除幽门螺杆菌有利于胃溃疡愈合。
研究哪些因素影响幽门螺杆菌感染的胃溃疡患者的溃疡愈合。
对230例幽门螺杆菌感染相关的胃溃疡患者进行前瞻性研究。长期服用非甾体抗炎药被视为排除标准。在初次内镜检查时，通过组织学排除恶性肿瘤，并在胃窦和胃体各取两块活检组织。此外，进行了ELISA IgG血清学检测和13C-尿素呼气试验。给予奥美拉唑（20毫克，每日两次）、克拉霉素（500毫克，每日两次）和阿莫西林（1克，每日两次）进行7天的根除治疗，随后奥美拉唑20毫克，每日一次，再持续5周。治疗6周后重复内镜检查，治疗结束2个月后重复呼气试验。
意向性治疗的情况下，总体胃溃疡愈合率为80.8%（95%可信区间：75 - 85%），符合方案分析的愈合率为82.6%（77 - 87%）。根除成功的患者溃疡愈合率为94.3%（90 - 97%），而根除失败的患者中仅为40.8%（28 - 54%）（p<0.0001）。多因素分析中，幽门螺杆菌根除是唯一与溃疡愈合相关的变量（比值比24；95%可信区间：10 - 56；p<0.0001）（x2模型：64.4；p<0.0001）。其他变量（年龄、性别、偶尔服用非甾体抗炎药、吸烟、既往溃疡病史、溃疡大小和位置）与愈合无关。
根除幽门螺杆菌有利于胃溃疡患者的溃疡愈合，这支持了该微生物在本病病因学中的作用。其他因素不影响溃疡愈合。
