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加德满都乔尔帕蒂尼泊尔医学院教学医院消化不良患者幽门螺杆菌感染患病率研究

Prevalence study of H. pylori infection in dyspeptic patients coming to Nepal Medical College Teaching Hospital, Jorpati, Kathmandu.

作者信息

Shrestha S, Paudel P, Pradhan G B, Shrestha L, Bhattachan C L

机构信息

Department of Surgery, Nepal Medical College Teaching Hospital, Kathmandu, Nepal.

出版信息

Nepal Med Coll J. 2012 Sep;14(3):229-33.

Abstract

Helicobacter pylori (H. pylori) is one of the most common human infections worldwide particularly in the developing countries. It has been established as etiology of chronic gastritis and peptic ulcer disease, gastric adenocarcinoma and mucosal associated lymphoid tissue lymphoma (MALT). During this decade, there have been some reports showing a decline in global prevalence of H. pylori infection and peptic diseases including many Asian countries. Hence to determine prevalence of Helicobacter pylori infection in dyspeptic patients, this descriptive, non-interventional study was carried out at the Endoscopy sub-unit of the Surgery Department from April 2011 to February 2012. Three hundred nineteen dyspeptic patients (Male 161 and female 152) with a mean age of 20.12 years were examined for the presence of H. pylori infection by histology staining. The prevalence of H. pylori infection was 50.47%. The most common endoscopic findings was gastritis (47.6%) followed by normal findings 57 (17.87%). A total of 8.47% of gastric Ulcer, oesophagitis 5.64% and gastric cancer 0.94% were detected. All three cases of gastric cancer were positive for H. pylori infection. Among gastritis, H. pylori was observed in 67 (44%) cases and 18 out of 57 (5.6%) of normal gastric mucosa showed H. pylori. The endoscopic findings such as gastritis, gastric ulcer, duodenal ulcer and gastro duodenal reflux are significantly associated with H. pyloric infection. The prevalence of H. pylori infection is still high in peptic diseases. H. pylori infection is significantly correlated with peptic ulcer diseases than with non-ulcer dyspepsia. Further studies are required to establish the H. pylori positive cases with that of other tests such as serological detection of anti H. pylori antibody by ELISA/ICT and culture to establish a diagnosis quickly without any invasive method and institute proper management thus reducing morbidity.

摘要

幽门螺杆菌(H. pylori)是全球最常见的人类感染之一,在发展中国家尤为如此。它已被确认为慢性胃炎、消化性溃疡病、胃腺癌和黏膜相关淋巴组织淋巴瘤(MALT)的病因。在这十年间,有一些报告显示包括许多亚洲国家在内,全球幽门螺杆菌感染和消化系统疾病的患病率有所下降。因此,为了确定消化不良患者中幽门螺杆菌感染的患病率,于2011年4月至2012年2月在外科内镜科室开展了这项描述性、非干预性研究。对319名消化不良患者(男性161名,女性152名)进行了检查,这些患者的平均年龄为20.12岁,通过组织学染色检测是否存在幽门螺杆菌感染。幽门螺杆菌感染的患病率为50.47%。最常见的内镜检查结果是胃炎(47.6%),其次是正常结果57例(17.87%)。共检测出胃溃疡8.47%、食管炎5.64%和胃癌0.94%。所有三例胃癌患者的幽门螺杆菌感染均呈阳性。在胃炎患者中,67例(44%)检测到幽门螺杆菌,57例正常胃黏膜中有18例(5.6%)显示有幽门螺杆菌。胃炎、胃溃疡、十二指肠溃疡和胃十二指肠反流等内镜检查结果与幽门螺杆菌感染显著相关。消化性疾病中幽门螺杆菌感染的患病率仍然很高。幽门螺杆菌感染与消化性溃疡疾病的相关性明显高于与非溃疡性消化不良的相关性。需要进一步研究将幽门螺杆菌阳性病例与其他检测方法(如通过酶联免疫吸附测定/免疫层析法血清学检测抗幽门螺杆菌抗体和培养)进行对比,以便在不采用任何侵入性方法的情况下快速确诊并进行适当管理,从而降低发病率。

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