悉尼分类系统与幽门螺杆菌相关性胃炎一线治疗疗效的关系。

The Relationship between the Sydney Classification and the First-Line Treatment Efficacy in Helicobacter-Associated Gastritis.

机构信息

Department of Internal Medicine, Acıbadem Mehmet Ali Aydınlar University School of Medicine, Istanbul, Turkey,

Department of Internal Medicine and Critical Care Unit, Düzce University School of Medicine, Düzce, Turkey.

出版信息

Med Princ Pract. 2020;29(6):551-557. doi: 10.1159/000508248. Epub 2020 Apr 28.

DOI:10.1159/000508248

PMID:32344409

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7768124/

Abstract

OBJECTIVE

Helicobacter pyloriis responsible for a wide spectrum of diseases. Due to ease of use and access, the standard triple therapy is being used as first-line eradication in many areas. Intestinal metaplasia (IM) is a precancerous lesion that requires eradication therapy. Our aim is to investigate the effect of IM on the standard triple therapy success in H. pylori-positive patients.

SUBJECTS AND METHODS

The patients who were referred to Düzce University Hospital and Avrasya Hospital Gastroenterohepatology clinic between January 2014 and December 2016 and diagnosed with H. pylori-positive gastritis and underwent first-line eradication were evaluated retrospectively. Biopsy specimens were evaluated according to the updated Sydney system. All patients diagnosed with H. pylori started treatment with pantoprazole 40 mg b.i.d., amoxicillin 1 g b.i.d. and clarithromycin 500 mg b.i.d. for 14 days.

RESULTS

The mean age of 181 patients included in the study was 55.5 ± 7.8. The success rate of H. pylori eradication was found to be low in severe chronic inflammation (p = 0.001). The success rate was found to be high among patients with no neutrophil activity (p = 0.009). As the intensity of IM increased, density of H. pylori was found to be decreased (p = 0.019). There was no correlation between glandular atrophy, IM, and H. pylori eradication success rate (p = 0.390 and p = 0.812).

CONCLUSION

The severity of chronic inflammation is the most effective Sydney criteria for success of eradication, while the presence on IM does not have any effect.

摘要

目的

幽门螺杆菌可引起广泛的疾病。由于使用方便且易于获得，标准三联疗法已在许多地区被用作一线根除方法。肠化生（IM）是一种癌前病变，需要进行根除治疗。我们旨在研究 IM 对 H. pylori 阳性患者标准三联疗法成功的影响。

受试者和方法

回顾性评估了 2014 年 1 月至 2016 年 12 月期间因 H. pylori 阳性胃炎而被转诊至 Düzce 大学医院和欧亚医院胃肠病学诊所并接受一线根除的患者。根据更新的悉尼系统评估活检标本。所有诊断为 H. pylori 的患者均开始接受泮托拉唑 40 mg bid、阿莫西林 1 g bid 和克拉霉素 500 mg bid 治疗，持续 14 天。

结果

纳入研究的 181 例患者的平均年龄为 55.5 ± 7.8 岁。重度慢性炎症患者的 H. pylori 根除成功率较低（p = 0.001）。无中性粒细胞活性的患者的成功率较高（p = 0.009）。随着 IM 强度的增加，H. pylori 的密度降低（p = 0.019）。腺体萎缩、IM 与 H. pylori 根除成功率之间无相关性（p = 0.390 和 p = 0.812）。