Vilaichone Ratha Korn, Wongcha Um Arti, Chotivitayatarakorn Peranart
Gastroenterology Unit, Thammasat University Hospital, Pathumthani, Thailand. Email:
Asian Pac J Cancer Prev. 2017 Mar 1;18(3):695-697. doi: 10.22034/APJCP.2017.18.3.695.
Background: H. pylori is an important cause of chronic gastritis, peptic ulcers and gastric cancer. Re-infection rates after successful eradication vary in different regions of the world but only limited studies have been performed in ASEAN Countries to clarify this important issue. The present study was designed to evaluate the H. pylori re-infection rate and predictors of re-infection in Thailand. Methods: We recruited patients with chronic gastritis after 1 and 2 years successful H. pylori eradication from Thammasat University Hospital, Pathumthani (Central urban area) and Maesod district, Tak (Northern rural area), Thailand. 13C-UBT was performed to evaluate re-infection status after cessation of PPI, H2 blocker and antibiotics for at least 4 weeks. Statistical analysis was performed using SPSS for Windows Version 22.0 (IBM Corp., Armonk, NY). Results: A total of 105 subjects were enrolled (40 M and 65F with a mean age of 53.1 years). The overall re-infection rate was 6/105 (5.7%). The 1-year and 2-year H. pylori re-infection rates after successful eradication were only 5.1% (2/39) and 6.1% (4/66). 1-year and 2-year reinfection rates in urban areas were 2/39 (5.1%) and 1/26 (3.8%), while the 2-year reinfection rate in rural areas was 3/40 (7.5%). Location (urban vs rural area) and sex did not show any association with either 1-year or 2-year H. pylori re-infection. With 2-year reinfection, the mean age of H. pylori re-infected patients was significantly higher than those who remained cured (63.0 years vs. 51.6 years, p-value = 0.01). The annual H. pylori infection rate was 2.9%. Conclusions: 1-year and 2-year H. pylori re-infection rates after successful eradication in Thailand appear low in both rural and urban areas. H. pylori eradication for prevention of significant upper GI disease should be recommended and confirmation of successful eradication should be the aim. Patients at higher risk such as the elderly should be monitored for possible risk of H. pylori re-infection.
幽门螺杆菌是慢性胃炎、消化性溃疡和胃癌的重要病因。根除成功后的再感染率在世界不同地区有所不同，但在东盟国家仅进行了有限的研究来阐明这一重要问题。本研究旨在评估泰国幽门螺杆菌的再感染率及再感染的预测因素。
我们从泰国巴吞他尼府的泰国国立法政大学医院（中部市区）和达府湄索县（北部农村地区）招募了幽门螺杆菌成功根除1年和2年后的慢性胃炎患者。在停用质子泵抑制剂、H2受体阻滞剂和抗生素至少4周后，进行13C-尿素呼气试验以评估再感染状况。使用SPSS for Windows版本22.0（IBM公司，纽约州阿蒙克）进行统计分析。
共纳入105名受试者（40名男性和65名女性，平均年龄53.1岁）。总体再感染率为6/105（5.7%）。成功根除后1年和2年的幽门螺杆菌再感染率分别仅为5.1%（2/39）和6.1%（4/66）。城市地区1年和2年的再感染率分别为2/39（5.1%）和1/26（3.8%），而农村地区2年的再感染率为3/40（7.5%）。地理位置（城市与农村地区）和性别与1年或2年的幽门螺杆菌再感染均无关联。在2年再感染的情况下，幽门螺杆菌再感染患者的平均年龄显著高于仍治愈的患者（63.0岁对51.6岁，p值 = 0.01）。幽门螺杆菌的年感染率为2.9%。
在泰国，成功根除幽门螺杆菌后1年和2年的再感染率在农村和城市地区似乎都较低。应推荐根除幽门螺杆菌以预防严重的上消化道疾病，并且应以确认成功根除为目标。对于老年人等高风险患者，应监测幽门螺杆菌再感染的可能风险。
