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减重手术患者中与幽门螺杆菌相关的流行情况及影响因素:SOON 队列研究。

Prevalence and Factors Associated with Helicobacter Pylori in Patients Undergoing Bariatric Surgery: the SOON Cohort.

机构信息

Nutrition Department, Grenoble Alpes University Hospital, Grenoble, France.

Hepato-Gastro-Enterology Outpatient Private Clinic "Les Cèdres", Grenoble, France.

出版信息

Obes Surg. 2018 Dec;28(12):3958-3964. doi: 10.1007/s11695-018-3440-4.

Abstract

PURPOSE

Helicobacter Pylori (HP) infection is systematically screened for before carrying out bariatric surgery. Criteria to determine "at risk" patients and avoid systematic screening are lacking. We evaluated the prevalence of HP infection and associated predictive factors in a population of patients with class II and III obesity volunteering for bariatric surgery.

MATERIALS AND METHODS

Observational, cross-sectional study of patients included in the severe obesity outcome network (SOON) cohort. All patients underwent HP screening. The relationship between plasma metabolic parameters and vitamin levels, medical history and socio-economic parameters, and HP infection was analyzed.

RESULTS

Data from 201 patients, median age 43 years [IQR 35; 52] (81% female) were analyzed. Forty-four patients (22%) were infected with HP and successfully treated, most with a single course of treatment, either combined antibiotics or Pylera®. HP infection was associated with social precariousness as defined by the French "Evaluation de la Précarité et des Inégalités de santé dans les Centres d'Examens de Santé" (EPICES) score (Evaluation of Poverty and Health Inequalities in Health-Assessment Centers) (OR, 1.027; 95% CI, 1.008-1.046; p < 0.004) and with higher levels of vitamin B (OR, 1.004; 95% CI, 1.001-1.007; p < 0.007).

CONCLUSION

The prevalence of HP infection was 22% and was associated with social precariousness. Plasma glucose/insulin and lipid/lipoprotein profiles, liver enzymes or vitamin deficiencies were not associated with HP infection. The number of characteristics associated with HP infection was insufficient to define patients who do not require HP screening before bariatric surgery.

摘要

目的

在进行减重手术前,系统筛查幽门螺杆菌(HP)感染。目前缺乏确定“高危”患者并避免系统筛查的标准。我们评估了肥胖 II 类和 III 类患者人群中 HP 感染的流行情况及其相关预测因素,这些患者志愿接受减重手术。

材料和方法

这是一项在严重肥胖结局网络(SOON)队列中纳入患者的观察性、横断面研究。所有患者均接受 HP 筛查。分析了血浆代谢参数与维生素水平、病史和社会经济参数之间的关系,以及与 HP 感染的关系。

结果

共纳入 201 例患者,中位年龄 43 岁[IQR 35;52](81%为女性),分析了其数据。44 例(22%)患者感染了 HP 并成功接受了治疗,大多数患者接受了单一疗程的治疗,要么是联合抗生素,要么是 Pylera®。HP 感染与法国“评估贫困和健康不平等状况在健康评估中心”(EPICES)评分定义的社会不稳定相关(OR,1.027;95%CI,1.008-1.046;p<0.004),且与维生素 B 水平较高相关(OR,1.004;95%CI,1.001-1.007;p<0.007)。

结论

HP 感染的流行率为 22%,与社会不稳定相关。血浆葡萄糖/胰岛素和血脂/脂蛋白谱、肝酶或维生素缺乏与 HP 感染无关。与 HP 感染相关的特征数量不足以确定哪些患者在接受减重手术前无需进行 HP 筛查。

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