Rattanachaisit Pakkapon, Burana Chuti, Jaroenlapnopparat Aunchalee, Vongseenin Sirikorn, Chaithongrat Supakarn, Rerknimitr Rungsun, Werawatganon Duangporn
Department of Physiology, Faculty of Medicine Chulalongkorn University and Center of Excellence in Alternative and Complementary Medicine for Gastrointestinal and Liver Diseases Bangkok Thailand.
Department of Medicine, Faculty of Medicine Chulalongkorn University Bangkok Thailand.
JGH Open. 2023 May 26;7(6):439-444. doi: 10.1002/jgh3.12916. eCollection 2023 Jun.
(HP) infection remains a significant global public health problem. This study aimed to study the prevalence of HP infection and treatment outcomes in Thailand.
We retrospectively reviewed the results of the urea breath test (UBT) performed at the King Chulalongkorn Memorial Hospital between 2018 and 2021. The prevalence of HP infection was evaluated in dyspeptic patients undergoing UBT screening. In patients with known HP infection, the treatment regimen and the success rate in each patient were recorded.
One-thousand nine-hundred and two patients were included in this study. The prevalence of HP infection in dyspeptic patients was 20.77% (UBT was positive in 65 out of 313 patients). Of the 1589 patients who received the first treatment regimen, 1352 (85.08%) had a negative UBT result. Patients who failed in each treatment regimen were treated with subsequent regimens. The overall success rates for the second, third, and fourth regimens were 69.87% (109 of 156 patients), 53.85% (14 of 26 patients), and 50% (3 of 6 patients), respectively. Univariate logistic regression analysis found that using lansoprazole was associated with failure of treatment with OR = 2.11 (95% CI: 1.14-3.92, = 0.018).
Current primary HP treatment regimens have an eradication rate of >80%. Even though the previous regimens failed, without available antibiotic sensitivity results, the subsequent regimens were successful by at least 50%. In cases of multiple-treatment failure and where antibiotic sensitivity tests were unavailable, continuing to change regimens could provide satisfactory results.
幽门螺杆菌(HP)感染仍是一个重大的全球公共卫生问题。本研究旨在探讨泰国HP感染的患病率及治疗效果。
我们回顾性分析了2018年至2021年在朱拉隆功国王纪念医院进行的尿素呼气试验(UBT)结果。对接受UBT筛查的消化不良患者评估HP感染的患病率。对于已知HP感染的患者,记录每位患者的治疗方案及成功率。
本研究纳入了1902例患者。消化不良患者中HP感染的患病率为20.77%(313例患者中有65例UBT呈阳性)。在接受第一种治疗方案的1589例患者中,1352例(85.08%)UBT结果为阴性。每种治疗方案治疗失败的患者接受后续方案治疗。第二、第三和第四种方案的总体成功率分别为69.87%(156例患者中有109例)、53.85%(26例患者中有14例)和50%(6例患者中有3例)。单因素逻辑回归分析发现,使用兰索拉唑与治疗失败相关,比值比(OR)=2.11(95%置信区间:1.14 - 3.92,P = 0.018)。
目前的HP一线治疗方案根除率>80%。即使之前的方案失败,在没有可用的抗生素敏感性结果的情况下,后续方案至少有50%的成功率。在多次治疗失败且无法进行抗生素敏感性试验的情况下,继续更换方案可获得满意结果。