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消化性溃疡出血再出血的预防:幽门螺杆菌根除与抑酸的作用

Prevention of the rehaemorrhage of bleeding peptic ulcers: effects of Helicobacter pylori eradication and acid suppression.

作者信息

Kikkawa A, Iwakiri R, Ootani H, Ootani A, Fujise T, Sakata Y, Amemori S, Tsunada S, Sakata H, Koyama T, Fujimoto K

机构信息

Department of Internal Medicine, Faculty of Medicine, Saga University, Nabeshima, Saga, Japan.

出版信息

Aliment Pharmacol Ther. 2005 Jun;21 Suppl 2:79-84. doi: 10.1111/j.1365-2036.2005.02479.x.

Abstract

AIM

This study aimed to investigate the consequences of Helicobacter pylori eradication and acid suppression on rehaemorrhage caused by bleeding peptic ulcers.

METHODS

A total of 320 patients who had been diagnosed with bleeding peptic ulcers between January 1994 and December 2001 were included in the study. Cases between 1994 and 1997, prior to the introduction of eradication therapy, were assigned to group A, whereas those between 1998 and 2001, after the eradication therapy, were assigned to group B.

RESULTS

Of the 320 cases, 162 were designated as group A (113 gastric ulcers and 49 duodenal ulcers) and 158 as group B (116 and 42, respectively). Rehaemorrhage occurred in 24 cases (15%) and five cases (3%) in groups A and B, respectively, presenting a significantly decreased rate of rehaemorrhage in group B. Among those without eradication, rehaemorrhage was observed in 15 of 128 cases (12%) that received treatment with histamine(2)-receptor antagonist (famotidine), and 14 of 142 cases (10%) treated with proton-pump inhibitors, with no significant difference between the two.

CONCLUSIONS

Helicobacter pylori eradication lowered the rates of rehaemorrhage. Treatment with histamine(2)-receptor antagonist or proton-pump inhibitors did not produce a difference in the rate of rehaemorrhage.

摘要

目的

本研究旨在探讨根除幽门螺杆菌和抑制胃酸对消化性溃疡出血再出血的影响。

方法

本研究纳入了1994年1月至2001年12月期间诊断为消化性溃疡出血的320例患者。1994年至1997年(根除治疗引入之前)的病例被分配到A组,而1998年至2001年(根除治疗之后)的病例被分配到B组。

结果

320例病例中,162例被指定为A组(胃溃疡113例,十二指肠溃疡49例),158例为B组(分别为116例和42例)。A组和B组分别有24例(15%)和5例(3%)发生再出血,B组再出血率显著降低。在未根除幽门螺杆菌的患者中,128例接受组胺-2受体拮抗剂(法莫替丁)治疗的患者中有15例(12%)出现再出血,142例接受质子泵抑制剂治疗的患者中有14例(10%)出现再出血,两者之间无显著差异。

结论

根除幽门螺杆菌可降低再出血率。使用组胺-2受体拮抗剂或质子泵抑制剂治疗在再出血率方面没有差异。

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