Cameron E A B, Bell G D, Baldwin L, Powell K U, Williams S G J
Department of Gastroenterology, Ipswich Hospital, Ipswich, UK.
Aliment Pharmacol Ther. 2006 May 1;23(9):1355-8. doi: 10.1111/j.1365-2036.2006.02899.x.
'Re-infection' with Helicobacter pylori after eradication has been estimated to occur in 0-14% of patients, although most so-called 're-infections' occur within the first year following 'eradication' and many may actually be due to recrudescence of a temporarily suppressed infection.
To study the true re-infection rate, we have studied re-infection rates after eradication therapy by excluding the first year's data, minimizing the possible confounding effect of recrudescence.
All patients tested for H. pylori infection following eradication therapy between 1987 and 2004 were evaluated. Testing was carried out by urea breath test and gastric biopsy. Patients were included if they were found to be negative for H. pylori infection by testing at least 1 year following eradication and underwent at least one further test for H. pylori.
1162 patients met the inclusion criteria with median post-eradication follow-up of 3 years (1.5-14) including 4668 tests; 3319 years of follow-up were analysed. Thirteen cases of re-infection occurred (re-infection rate 0.4% per year).
This large study of H. pylori re-infection avoided cases of recrudescence by excluding the first post-eradication year. True re-infection is probably less common than previously thought.
幽门螺杆菌根除治疗后“再次感染”的发生率据估计在0%至14%之间，不过大多数所谓的“再次感染”发生在“根除”后的第一年，而且许多可能实际上是由于暂时被抑制的感染复发所致。
为研究真正的再次感染率，我们通过排除第一年的数据来研究根除治疗后的再次感染率，以尽量减少复发可能产生的混杂效应。
对1987年至2004年间接受根除治疗后检测幽门螺杆菌感染的所有患者进行评估。检测采用尿素呼气试验和胃活检。如果患者在根除治疗后至少1年检测发现幽门螺杆菌感染呈阴性且至少接受过一次进一步的幽门螺杆菌检测，则纳入研究。
1162例患者符合纳入标准，根除治疗后的中位随访时间为3年（1.5至14年），共进行了4668次检测；分析了3319年的随访数据。发生了13例再次感染（每年的再次感染率为0.4%）。
这项关于幽门螺杆菌再次感染的大型研究通过排除根除后的第一年避免了复发情况。真正的再次感染可能比之前认为的更为少见。
