幽门螺杆菌感染在开始 NSAID 治疗的患者的胃十二指肠损伤中的作用：4 个月随访研究。
Role of Helicobacter pylori infection in gastroduodenal damage in patients starting NSAID therapy: 4 Months follow-up study.
机构信息
Clinic for Gastroenterology and Hepatology, Institute for Digestive Diseases, Clinical Center of Serbia, University of Belgrade, Koste Todorovica 6, 11 000, Belgrade, Serbia.
出版信息
Dig Dis Sci. 2010 Oct;55(10):2887-92. doi: 10.1007/s10620-009-1097-5. Epub 2010 Jan 22.
AIMS
We aimed to determine differences in gastroduodenal damage related to the presence of Helicobacter pylori (Hp) in patients starting long-term NSAID therapy. Seventy-one candidates for chronic NSAIDs therapy (33 Hp negative and 38 Hp positive) entered the study and underwent upper GI endoscopy before, and 8 and 16 weeks after, continuous NSAID therapy.
RESULTS
Lanza score increased in both Hp positive and negative patients in the course of NSAID therapy (P < 0.001), being significantly higher in Hp positive than Hp negative (4.31 ± 1.33 vs 3.15 ± 1.95, P < 0.05) after 16 weeks of follow-up. In gastric mucosa, no significant difference in mean Lanza score was observed between the two groups. Duodenal ulcer was diagnosed in 18 (36.8%) Hp positive and 1 (3%) Hp negative patient (P < 0.05).
CONCLUSIONS
Hp is more closely related to duodenal than gastric mucosal injury in NSAID users. Risk for duodenal ulcer in Hp-infected individual increases after 4 months of NSAID therapy.
目的
本研究旨在确定长期使用非甾体抗炎药（NSAIDs）治疗的患者中，与幽门螺杆菌（Hp）存在相关的胃十二指肠损伤的差异。71 名候选慢性 NSAIDs 治疗患者（33 名 Hp 阴性和 38 名 Hp 阳性）入组本研究，并在 NSAIDs 治疗前、治疗 8 周和 16 周后接受上消化道内镜检查。
结果
在 NSAIDs 治疗过程中，Hp 阳性和阴性患者的 Lanza 评分均升高（P < 0.001），在 16 周随访后，Hp 阳性患者的评分明显高于 Hp 阴性患者（4.31 ± 1.33 比 3.15 ± 1.95，P < 0.05）。在胃黏膜中，两组之间的平均 Lanza 评分无显著差异。在 Hp 阳性患者中有 18 例（36.8%）诊断为十二指肠溃疡，而在 Hp 阴性患者中仅有 1 例（3%）（P < 0.05）。
结论
在 NSAIDs 使用者中，Hp 与十二指肠黏膜损伤的关系比与胃黏膜损伤的关系更密切。在 NSAIDs 治疗 4 个月后，Hp 感染个体发生十二指肠溃疡的风险增加。
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