Forbes G M, Glaser M E, Cullen D J, Warren J R, Christiansen K J, Marshall B J, Collins B J
Department of Gastroenterology, Royal Perth Hospital, Western Australia.
Lancet. 1994 Jan 29;343(8892):258-60. doi: 10.1016/s0140-6736(94)91111-8.
The long-term benefits of Helicobacter pylori-eradication treatment (HET) in H pylori-associated duodenal ulcer are unclear. We followed up patients with duodenal ulcers from a trial of H pylori eradication in 1985-86. 63 of 78 patients (81%) were reviewed clinically and had upper gastrointestinal endoscopy with gastric antral biopsy. Of 35 patients previously rendered H pylori negative, 32 (92%) remained H pylori negative after 7.1 years (mean). All patients initially H pylori positive remained infected, unless HET was given in the interim. Duodenal ulceration was found in 20% (5 out of 25) of patients remaining H pylori-positive, compared with 3% (1 of 38) of H pylori-negative patients (p < 0.05). The reduction of duodenal ulcer relapse obtained from H pylori eradication in H pylori-associated duodenal ulcer extends to at least 7 years after treatment, and is likely to be due to freedom from H pylori infection. However, duodenal ulcer may recur in patients rendered H pylori negative, due to factors other than reinfection with H pylori.
幽门螺杆菌根除治疗（HET）对幽门螺杆菌相关十二指肠溃疡的长期益处尚不清楚。我们对1985 - 1986年一项幽门螺杆菌根除试验中的十二指肠溃疡患者进行了随访。78例患者中有63例（81%）接受了临床复查，并进行了上消化道内镜检查及胃窦活检。在之前已使幽门螺杆菌转阴的35例患者中，平均7.1年后有32例（92%）仍保持幽门螺杆菌阴性。所有最初幽门螺杆菌阳性的患者仍处于感染状态，除非在此期间接受了HET治疗。在仍为幽门螺杆菌阳性的患者中，20%（25例中的5例）出现了十二指肠溃疡，而幽门螺杆菌阴性患者中这一比例为3%（38例中的1例）（p < 0.05）。幽门螺杆菌根除治疗使幽门螺杆菌相关十二指肠溃疡的十二指肠溃疡复发率降低，这种降低在治疗后至少持续7年，并且可能是由于摆脱了幽门螺杆菌感染。然而，幽门螺杆菌转阴的患者可能会因幽门螺杆菌再感染以外的因素而复发十二指肠溃疡。
