Tatsuta M, Iishi H, Yokota Y
Department of Gastrointestinal Oncology, Center for Adult Diseases, Osaka, Japan.
Am J Gastroenterol. 1995 Mar;90(3):406-10.
The effects of Helicobacter pylori infection on the healing and recurrence of gastric ulcers were investigated.
Eighty-five and 17 patients with endoscopically-proven gastric ulcer with and without H. pylori infection, respectively, received 800 mg of cimetidine daily. Healing of ulcer and H. pylori infection were assessed at wk 12. After the 12-wk-treatment period, 67 and 16 patients with healed ulcer positive and negative for H. pylori infection, respectively, received maintenance treatment (cimetidine 400 mg daily). Ulcer recurrence and H. pylori infection were assessed at or within 24 wk from the beginning of maintenance treatment. Variables influencing ulcer healing and recurrence were analyzed by multiple regression analysis.
Ulcer healing at wk 12 was similar in patients with and without H. pylori infection, occurring in 16 (89%) of 18 patients without H. pylori infection, compared with 67 (87%) of 77 patients with H. pylori infection. At or within 24 wk from the start of maintenance therapy, ulcer recurrence was significantly more frequent in patients with H. pylori infection than in those without: it occurred in three (20%) of 15 patients without H. pylori infection, but in 37 (58%) of 64 patients with infection. Multiple regression analysis showed that H. pylori infection was related most closely to ulcer recurrence independently.
H. pylori infection had a significant independent influence on gastric ulcer recurrence, but not initial ulcer healing.
研究幽门螺杆菌感染对胃溃疡愈合及复发的影响。
85例经内镜证实的幽门螺杆菌感染的胃溃疡患者和17例未感染幽门螺杆菌的胃溃疡患者,均每日服用800毫克西咪替丁。在第12周时评估溃疡愈合情况及幽门螺杆菌感染情况。在为期12周的治疗期结束后,67例幽门螺杆菌感染阳性且溃疡已愈合的患者和16例幽门螺杆菌感染阴性且溃疡已愈合的患者,分别接受维持治疗(每日400毫克西咪替丁)。从维持治疗开始起24周内评估溃疡复发及幽门螺杆菌感染情况。通过多元回归分析来分析影响溃疡愈合及复发的变量。
第12周时,幽门螺杆菌感染阳性和阴性患者的溃疡愈合情况相似,18例未感染幽门螺杆菌的患者中有16例(89%)愈合,77例感染幽门螺杆菌的患者中有67例(87%)愈合。在维持治疗开始后24周内,幽门螺杆菌感染患者的溃疡复发明显比未感染患者更频繁:15例未感染幽门螺杆菌的患者中有3例(20%)复发,而64例感染患者中有37例(58%)复发。多元回归分析表明,幽门螺杆菌感染与溃疡复发独立相关最为密切。
幽门螺杆菌感染对胃溃疡复发有显著的独立影响,但对初始溃疡愈合无影响。