立陶宛消化性溃疡患者幽门螺杆菌再感染率高。
High rate of Helicobacter pylori reinfection in Lithuanian peptic ulcer patients.
作者信息
Jonaitis Laimas, Kiudelis Gediminas, Slepavicius Paulius, Kupcinskas Limas
机构信息
Laimas Jonaitis, Gediminas Kiudelis, Paulius Slepavicius, Limas Kupcinskas, Department of Gastroenterology, Medical Academy, Lithuanian University of Health Sciences, LT-50028 Kaunas, Lithuania.
出版信息
World J Gastrointest Pathophysiol. 2016 Feb 15;7(1):181-5. doi: 10.4291/wjgp.v7.i1.181.
AIM
To evaluate the frequency of Helicobacter pylori (H. pylori) reinfection in peptic ulcer patients during 9 years after H. pylori eradication.
METHODS
We invited 117 peptic ulcer patients in whom eradication of H. pylori was confirmed 1 year after eradication treatment both by histology and by rapid urease test. In total, 57 patients were available for the study procedures: 34 (59.6%) male, 23 (40.4%) female; mean age 52.3 ± 13.0 years. There were 45 (78.9%) patients with duodenal ulcer and 12 (21.1%) with gastric ulcer. H. pylori was diagnosed by a rapid urease test and histology if endoscopy was performed. If endoscopy was refused, H. pylori was diagnosed by the C14-urea breath test and serology. H. pylori was established if at least one of the tests was positive.
RESULTS
The mean follow-up was 8.9 ± 1.0 years (range, 6-12). H. pylori was established in 15 patients. In 2 H. pylori-negative patients, H. pylori was established during the follow-up period and eradicated. Therefore, we consider that reinfection occurred in 17 patients. In the per protocol analysis, reinfection was established in 17 of 57 (29.8%; 95%CI: 19.2-42.2) patients during the follow-up period. The annual rate of infection was 3.36%. If all non-responders were considered H. pylori-negative, reinfection would be 14.5% (17/117), the annual rate being 1.63%. The mean age of patients with reinfection was 51.8 ± 14.0 years, and without reinfection was 52.5 ± 13.0 years, P > 0.05; the mean body mass index of patients with reinfection was 27.2 ± 4.1 kg/m(2), and without reinfection was 25.7 ± 4.2 kg/m(2), P > 0.05. There were no differences in the reinfection rates according the location of the peptic ulcer, the eradication regimen used, and smoking status.
CONCLUSION
The reinfection rate of H. pylori is relatively high in Lithuania and probably related to the high prevalence of H. pylori, what may reflect differences in the socioeconomic status between Western and Eastern European countries.
目的
评估幽门螺杆菌（H. pylori）根除后9年内消化性溃疡患者幽门螺杆菌再感染的频率。
方法
我们邀请了117例消化性溃疡患者，这些患者在根除治疗1年后经组织学和快速尿素酶试验证实幽门螺杆菌已被根除。总共有57例患者可用于研究流程：男性34例（59.6%），女性23例（40.4%）；平均年龄52.3±13.0岁。十二指肠溃疡患者45例（78.9%），胃溃疡患者12例（21.1%）。如果进行了内镜检查，通过快速尿素酶试验和组织学诊断幽门螺杆菌。如果拒绝内镜检查，则通过C14尿素呼气试验和血清学诊断幽门螺杆菌。如果至少一项检查呈阳性，则确定存在幽门螺杆菌。
结果
平均随访时间为8.9±1.0年（范围6 - 12年）。15例患者确定存在幽门螺杆菌。在2例幽门螺杆菌阴性患者中，随访期间确定存在幽门螺杆菌并予以根除。因此，我们认为17例患者发生了再感染。在符合方案分析中，随访期间57例患者中有17例（29.8%；95%CI：19.2 - 42.2）发生再感染。年感染率为3.36%。如果将所有无反应者视为幽门螺杆菌阴性，再感染率将为14.5%（17/117），年感染率为1.63%。再感染患者的平均年龄为51.
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