Miehlke S, Lehn N, Meining A, Bästlein E, Mannes G A, Stolte M, Bayerdörffer E
Department of Gastroenterology, Hepatology and Infectious Diseases, University of Magdeburg, Germany.
Eur J Gastroenterol Hepatol. 1996 Dec;8(12):1161-3. doi: 10.1097/00042737-199612000-00005.
Cure of H. pylori infection in peptic ulcer patients significantly reduces the risk of ulcer recurrence. Since data on the rate of H. pylori reinfection in patients undergoing successful anti-H. pylori therapy are sparse, this study was conducted with the aim of determining the H. pylori reinfection rate in peptic ulcer patients receiving antibacterial treatment to heal their ulcer and cure H. pylori infection.
A total of 217 patients with H. pylori-associated duodenal or gastric ulcer were followed up after treatment with various antibacterial regimens resulting in histologically documented cure of H. pylori infection. Endoscopic and histological examinations were performed 4 weeks after completion of treatment and after 1, 2 and 5 years, or whenever dyspeptic symptoms occurred. To assess the H. pylori status two antral and two corpus biopsies were obtained for histological examination.
Out of 217 patients with initially cured H. pylori infection 175 were available for endoscopic follow-up. At the time of analysis, 44 patients were re-examined after 1 year, 113 patients after 2 years and 18 patients after 5 years, giving a total of 360 patient years of follow-up. The mean duration of follow-up was 24.7 months. H. pylori reinfection was confirmed histologically in eight patients, three of whom becoming H. pylori-positive again within the first year of follow-up. Six of the eight patients with H. pylori reinfection also suffered an ulcer relapse. Eight cases of reinfection in 360 patient years represents an overall reinfection rate of 2.2%. Within the first 2 years of follow-up the reinfection rate was 0.8% per year.
Our data suggest that H. pylori reinfection is rare in peptic ulcer patients receiving successful anti-H. pylori therapy. H. pylori reinfection frequently coincides with ulcer recurrence. Cure of H. pylori infection results in cure of peptic ulcer disease, provided H. pylori reinfection does not occur.
消化性溃疡患者幽门螺杆菌感染的治愈可显著降低溃疡复发风险。由于关于成功根除幽门螺杆菌治疗的患者中幽门螺杆菌再感染率的数据较少，本研究旨在确定接受抗菌治疗以治愈溃疡和幽门螺杆菌感染的消化性溃疡患者的幽门螺杆菌再感染率。
共有217例幽门螺杆菌相关性十二指肠溃疡或胃溃疡患者在接受各种抗菌方案治疗后进行随访，治疗后组织学检查证实幽门螺杆菌感染已治愈。治疗结束后4周、1年、2年和5年或出现消化不良症状时进行内镜和组织学检查。为评估幽门螺杆菌状态，取两块胃窦和两块胃体活检组织进行组织学检查。
217例最初幽门螺杆菌感染已治愈的患者中，175例可进行内镜随访。分析时，44例患者在1年后复查，113例患者在2年后复查，18例患者在5年后复查，总计随访360患者年。平均随访时间为24.7个月。8例患者经组织学证实有幽门螺杆菌再感染，其中3例在随访的第一年内再次幽门螺杆菌阳性。8例幽门螺杆菌再感染患者中有6例也出现了溃疡复发。360患者年中有8例再感染病例，总体再感染率为2.2%。随访的前2年内，再感染率为每年0.8%。
我们的数据表明，在接受成功的幽门螺杆菌治疗的消化性溃疡患者中，幽门螺杆菌再感染很少见。幽门螺杆菌再感染常与溃疡复发同时发生。如果不发生幽门螺杆菌再感染，幽门螺杆菌感染的治愈可导致消化性溃疡疾病的治愈。
