Department of Internal Medicine, West Virginia University Health Sciences Center, Charleston Division, 25303, USA.
Am J Med. 2011 Mar;124(3):260-4. doi: 10.1016/j.amjmed.2010.11.013.
To determine if endoscopic Helicobacter pylori and peptic ulcer disease prevalence has changed over an 11-year period in a rural region.
Current endoscopic records were reviewed and compared with similar data obtained over a time period 11 years earlier at the same institution with regard to H. pylori status, endoscopic findings, microscopic pathologic findings, and medication use.
There were 251 records reviewed in the current study group (mean age 52.8 years, 59.0% female) and 263 in the previous group (mean age 60.1 years, 56.7% female). H. pylori was positive in 17 (6.8%) in the current study and 173 (65.8%) in the earlier study (P <.0001). Peptic ulcer disease (PUD) was present in 14 (5.6%) in the current study and in 102 (38.8%) in the earlier study (P <.0001). H. pylori was positive in 1 of the 14 PUD patients (7.1%) in the current study and in 78 of 102 (76.5%) in the previous study (P <.0001).
Endoscopic H. pylori prevalence in our rural locality has decreased substantially over the past decade and may reflect local overall prevalence trends, although underestimation is likely due to widespread prior noninvasive H. pylori diagnosis and treatment. Endoscopic PUD also has decreased precipitously, possibly related to changes in regional H. pylori characteristics and prolific use of antisecretory agents. Changing geographic trends regarding acid-peptic disease may prompt modification of diagnostic approach and treatment.
在农村地区，确定在 11 年的时间内，内镜幽门螺杆菌和消化性溃疡疾病的患病率是否发生了变化。
对当前的内镜记录进行了回顾，并与同一机构 11 年前的相似数据进行了比较，比较的内容包括 H. pylori 状态、内镜发现、显微镜病理发现和药物使用情况。
本研究组共回顾了 251 份记录（平均年龄 52.8 岁，59.0%为女性），前一组为 263 份记录（平均年龄 60.1 岁，56.7%为女性）。在当前研究组中，H. pylori 阳性率为 17（6.8%），而在前一组中为 173（65.8%）（P<.0001）。在当前研究组中，14 例（5.6%）患有消化性溃疡病（PUD），而在前一组中为 102 例（38.8%）（P<.0001）。在当前研究组中，14 例 PUD 患者中有 1 例（7.1%）H. pylori 阳性，而在前一组中，102 例中有 78 例（76.5%）H. pylori 阳性（P<.0001）。
在过去的十年中，我们农村地区内镜检查 H. pylori 的患病率大幅下降，这可能反映了当地总体流行趋势，尽管由于广泛的既往非侵入性 H. pylori 诊断和治疗，可能存在低估。内镜 PUD 也急剧下降，这可能与区域性 H. pylori 特征的变化和大量使用抗分泌药物有关。胃酸相关疾病的地理变化趋势可能会促使诊断方法和治疗方法的改变。
