Hu Y, Wan J-H, Li X-Y, Zhu Y, Graham D Y, Lu N-H
Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
Department of Medicine, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, TX, USA.
Aliment Pharmacol Ther. 2017 Nov;46(9):773-779. doi: 10.1111/apt.14319. Epub 2017 Sep 11.
Up-to-date information regarding the recurrence rate of Helicobacter pylori (H. pylori) after eradication therapy is not available.
To evaluate the global recurrence rate following H. pylori eradication therapy and confirm its association with socioeconomic and sanitary conditions.
A systematic search of PubMed, EMBASE and the Cochrane library was performed to identify potentially relevant publications using the following keywords: "Helicobacter pylori" or "H. pylori" or "Hp" and "recurrence" or "recrudescence" or "reinfection" or "recurrent" or "recurred" or "re-infect*" or "relapse*."
A total of 132 studies (53 934 patient-years) were analysed. Each study was weighted according to the duration of patient-years. The global annual recurrence, reinfection and recrudescence rate of H. pylori were 4.3% (95% CI, 4-5), 3.1% (95% CI, 2-5) and 2.2% (95% CI, 1-3), respectively. The H. pylori recurrence rate was inversely related to the human development index (HDI) (ie, 3.1% [95% CI, 2-4], 6.2% [95% CI, 4-8] and 10.9% [95% CI, 6-18] in countries with a very high, high and medium or low HDI) (P <.01) and directly related to H. pylori prevalence (10.9% [95% CI, 7-16], 3.7% [95% CI, 3-5], 3.4% [95% CI, 2-5] and 1.6% [95% CI, 0.5-3] in countries with a very high, high, medium or low local H. pylori prevalence) (P <.01). Global recurrence rates remained relatively stable between 1990s, 2000s and 2010s but varied across different regions (P <.05).
H. pylori recurrence remains a problem closely associated with socioeconomic and sanitary conditions. Methods to reduce recurrence in developing countries are needed.
目前尚无关于幽门螺杆菌（H. pylori）根除治疗后复发率的最新信息。
评估幽门螺杆菌根除治疗后的全球复发率，并确认其与社会经济和卫生条件的关联。
对PubMed、EMBASE和Cochrane图书馆进行系统检索，以使用以下关键词识别潜在相关出版物：“Helicobacter pylori”或“H. pylori”或“Hp”以及“recurrence”或“recrudescence”或“reinfection”或“recurrent”或“recurred”或“re-infect*”或“relapse*”。
共分析了132项研究（53934患者年）。每项研究根据患者年数进行加权。幽门螺杆菌的全球年复发率、再感染率和复发率分别为4.3%（95%CI，4 - 5）、3.1%（95%CI，2 - 5）和2.2%（95%CI，1 - 3）。幽门螺杆菌复发率与人类发展指数（HDI）呈负相关（即人类发展指数非常高、高、中等或低的国家中分别为3.1%[95%CI，2 - 4]、6.2%[95%CI，4 - 8]和10.9%[95%CI，6 - 18]）（P <.01），与幽门螺杆菌流行率呈正相关（当地幽门螺杆菌流行率非常高、高、中等或低的国家中分别为10.9%[95%CI，7 - 16]、3.7%[95%CI，3 - 5]、3.4%[95%CI，2 - 5]和1.6%[95%CI，0.5 - 3]）（P <.01）。全球复发率在20世纪90年代、21世纪00年代和21世纪10年代之间保持相对稳定，但不同地区有所差异（P <.05）。
幽门螺杆菌复发仍然是一个与社会经济和卫生条件密切相关的问题。发展中国家需要采取减少复发的方法。
