Zhou Li Ya, Song Zhi Qiang, Xue Yan, Li Xiao, Li Yan Qing, Qian Jia Ming
Department of Gastroenterology, Peking University Third Hospital, Beijing, China.
Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong Province, China.
J Dig Dis. 2017 Jan;18(1):47-55. doi: 10.1111/1751-2980.12440.
Recurrence of Helicobacter pylori (H. pylori) infection weakens the protective effect and long-term prognosis of eradication. With the widespread therapies, decreasing prevalence of H. pylori infection and improvement in living conditions, the recurrence of H. pylori infection may present with new features. We conducted this prospective, large-scale, multicenter follow-up study to determine the recurrence rate of H. pylori infection and its affecting factors.
A total of 827 patients receiving successful H. pylori eradication in our previous randomized controlled trial were enrolled. C-urea breath test (UBT) was repeated one year after the eradication therapy to determine its recurrence. Moreover, a questionnaire survey was performed to explore the potential factors affecting the recurrence.
A total of 743 patients completed C-UBT (follow-up rate 89.8%), and the result was positive in 13 patients one year after eradication therapy, with an annual recurrence rate of 1.75% (95% confidence interval [CI] 0.81-2.69%). Six hundred and ninety-two patients (13 with recurrence and 679 without recurrence) returned their questionnaires, with a response rate of >80%. Multivariate analysis revealed that peptic ulcer (odds ratio [OR] 3.385, 95% CI 1.016-11.274), close contact with individuals having H. pylori infection (OR 4.231, 95% CI 1.201-14.911), and hospitalization (OR 9.302, 95% CI 2.441-35.440) were independent risk factors of H. pylori infection recurrence.
The recurrence of H. pylori infection one year after eradication therapy is low in urban population of China. Peptic ulcer, contact history with individuals having H. pylori infection and hospitalization are risk factors.
幽门螺杆菌(H. pylori)感染复发会削弱根除治疗的保护作用及长期预后。随着治疗方法的广泛应用、H. pylori感染率的下降以及生活条件的改善,H. pylori感染复发可能呈现新特点。我们开展了这项前瞻性、大规模、多中心随访研究,以确定H. pylori感染的复发率及其影响因素。
纳入我们之前一项随机对照试验中827例成功根除H. pylori的患者。根除治疗1年后重复进行碳-尿素呼气试验(UBT)以确定是否复发。此外,进行问卷调查以探究影响复发的潜在因素。
共有743例患者完成了碳-UBT(随访率89.8%),根除治疗1年后13例患者结果呈阳性,年复发率为1.75%(95%置信区间[CI] 0.81 - 2.69%)。692例患者(13例复发,679例未复发)返回了问卷,回复率>80%。多因素分析显示,消化性溃疡(比值比[OR] 3.385,95% CI 1.016 - 11.274)、与H. pylori感染者密切接触(OR 4.231,95% CI 1.201 - 14.911)以及住院(OR 9.302,95% CI 2.441 - 35.440)是H. pylori感染复发的独立危险因素。
中国城市人群中,根除治疗1年后H. pylori感染复发率较低。消化性溃疡、与H. pylori感染者接触史及住院是危险因素。