Department of Gastroenterology, Peking University Third Hospital, Beijing 100191, China.
Chin Med J (Engl). 2019 Apr 5;132(7):765-771. doi: 10.1097/CM9.0000000000000146.
Helicobacter pylori (H. pylori) eradication has been widely used. The recurrence rate of H. pylori after eradication and its related factors are gaining more and more attention. Our study aimed to determine the recurrence rate of H. pylori infection after successful eradication, and analyze its influential factors.
We prospectively studied 1050 patients with upper gastrointestinal symptoms who were diagnosed as H. pylori infection by gastroscopy and underwent eradication therapies from April 2013 to January 2014. The C-urea breath test (UBT) or Warthin-Starry (WS) staining was done at 8 to 12 weeks after the therapy. Patients with successful eradication were followed by repeated UBT or gastroscopy at one year and 3 years after therapy, as well as, questionnaire surveys. Recurrence was considered if the UBTs or WS staining of biopsy were positive. One-year and 3-year recurrence rates were calculated, and analyzed the differences between recurred patients and others in basic data, sociological characteristics, lifestyle.
A total of 743 patients finished the 1-year follow-up, and the 1-year recurrence rate was 1.75%. Of the 607 patients who finished the 3-year follow-up, 28 patients recurred, and the 3-year recurrence rate was 4.61%. Analysis of variance showed that low-income, poor hygiene condition of dining out place, and receiving invasive diagnoses or treatments were significant risk factors for H. pylori infection recurrence. Logistic regression analysis demonstrated that the combination of invasive diagnoses or treatments, the level of income, and the hygiene standard of dining out place were significant and independent influential factors of the recurrence of H. pylori.
The 1-year and 3-year recurrence rates of H. pylori infection after eradication therapy are 1.75% and 4.61%. Low-income, poor hygiene condition of dining out place, and a combination of invasive diagnoses or treatments are independent risk factors of H. pylori recurrence.
幽门螺杆菌（H. pylori）的根除已被广泛应用。H. pylori 根除后的复发率及其相关因素越来越受到关注。本研究旨在确定 H. pylori 感染根除后复发的发生率，并分析其影响因素。
我们前瞻性研究了 2013 年 4 月至 2014 年 1 月因上消化道症状行胃镜检查并接受根除治疗的 1050 例 H. pylori 感染患者。治疗后 8-12 周行 C-尿素呼气试验（UBT）或华-史染色检查。成功根除的患者在治疗后 1 年和 3 年分别行 UBT 或胃镜检查，并进行问卷调查。如果活检 UBT 或华-史染色阳性，则认为复发。计算 1 年和 3 年的复发率，并分析复发患者与其他患者在基本资料、社会人口学特征、生活方式方面的差异。
共 743 例患者完成 1 年随访，1 年复发率为 1.75%。607 例完成 3 年随访的患者中，28 例复发，3 年复发率为 4.61%。方差分析显示，低收入、外出就餐卫生条件差、接受有创诊断或治疗是 H. pylori 感染复发的显著危险因素。Logistic 回归分析表明，有创诊断或治疗的联合应用、收入水平和外出就餐卫生标准是 H. pylori 复发的显著独立影响因素。
H. pylori 根除治疗后 1 年和 3 年的复发率分别为 1.75%和 4.61%。低收入、外出就餐卫生条件差、有创诊断或治疗的联合应用是 H. pylori 复发的独立危险因素。
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