Iserhard R, Freise J, Wagner S, Bokemeyer B, Weissbrodt H, Fritsch R S, Soudah B, Schmidt F W
Dept. of Gastroenterology and Hepatology, Medizinische Hochschule Hannover.
Hepatogastroenterology. 1990 Dec;37 Suppl 2:38-44.
Two-hundred and ten consecutive patients undergoing routine gastroscopy were additionally investigated for evidence of Campylobacter pylori (C.p.). 106 patients were positive in one or more tests: 99.1% using a rapid urease detecting test (CLO-test), 80.2% histology, 78.3% cytology and 60% culture. We found no difference between the CLO-test results from biopsies taken from different parts of the stomach in individual patients. C.p. was found in 100% of patients with significant chronic antral gastritis, 67.7% with gastric ulcers, 65% with duodenal ulcers and in 12.1% of normal individuals. The C.p. infection was apparently eliminated in 50% of cases treated with bismuth subsalicylate (BSS) for four weeks. The combination of BSS with amoxicillin, tinidazole or an H2-receptor antagonist offered no advantage over BSS alone. Treatment with BSS led to improvement in symptoms and histological findings including healing of ulcers in patients with or without persistent C.p. infection. The recurrence of C.p. infection after apparently successful treatment was, however, 75% in 4 weeks. In conclusion, C.p. infection correlates strongly with the presence of chronic gastritis, and significantly with gastric and duodenal ulceration. The best diagnostic approach is the combination of a rapid urease detecting test and histology. C.p. infection is of long duration and difficult to eliminate. The most effective treatment for C.p. infection remains BSS as single agent.
对210例接受常规胃镜检查的连续患者额外进行了幽门螺杆菌（C.p.）感染证据的调查。106例患者一项或多项检测呈阳性：快速尿素酶检测试验（CLO试验）阳性率为99.1%，组织学检查为80.2%，细胞学检查为78.3%，培养为60%。我们发现，个体患者胃不同部位活检的CLO试验结果之间没有差异。在100%的重度慢性胃窦炎患者、67.7%的胃溃疡患者、65%的十二指肠溃疡患者以及12.1%的正常个体中发现了C.p.。用次水杨酸铋（BSS）治疗四周后，50%的病例中C.p.感染明显消除。BSS与阿莫西林、替硝唑或H2受体拮抗剂联合使用相比单独使用BSS并无优势。BSS治疗使症状和组织学结果得到改善，包括有或无持续性C.p.感染患者的溃疡愈合。然而，在明显成功治疗后四周，C.p.感染的复发率为75%。总之，C.p.感染与慢性胃炎的存在密切相关，与胃溃疡和十二指肠溃疡显著相关。最佳诊断方法是快速尿素酶检测试验和组织学检查相结合。C.p.感染持续时间长且难以消除。治疗C.p.感染最有效的药物仍然是单剂BSS。
