Ng E K, Chung S C, Sung J J, Lam Y H, Lee D W, Lau J Y, Ling T K, Lau W Y, Li A K
Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong.
Br J Surg. 1996 Dec;83(12):1779-81. doi: 10.1002/bjs.1800831237.
There has been controversy regarding the relationship between Helicobacter pylori and perforated peptic ulcer, which is known to have a high recurrence rate if only simple patch repair is performed. The aim of this study was to evaluate the association between H. pylori infection and intake of non-steroidal anti-inflammatory drugs (NSAIDs) in patients with perforated duodenal ulcers. Of the 73 patients recruited over a 16-month period, 51 (70 per cent) had evidence of H. pylori infection by intraoperative gastroscopy and antral biopsies. The infection rate rose to 80 per cent if NSAID users were excluded. The H. pylori-infected group was significantly younger (mean 47.6 versus 62.5 years), with a male preponderance (49 of 51 versus 14 of 22 patients), and had significantly less NSAID consumption (three of 51 versus ten of 22) and more prolonged dyspepsia (40 of 51 versus ten of 22), compared with H. pylori-negative patients. H. pylori infection probably plays an important role in the causation of non-NSAID-induced duodenal ulcer perforation. Whether eradication of the bacteria can alleviate the strong ulcer diathesis in this subgroup of patients is unknown.
幽门螺杆菌与穿孔性消化性溃疡之间的关系一直存在争议，已知如果仅进行简单的修补术，穿孔性消化性溃疡的复发率很高。本研究的目的是评估十二指肠溃疡穿孔患者中幽门螺杆菌感染与非甾体抗炎药（NSAIDs）摄入之间的关联。在16个月期间招募的73例患者中，51例（70%）通过术中胃镜检查和胃窦活检有幽门螺杆菌感染的证据。如果排除NSAIDs使用者，感染率上升至80%。与幽门螺杆菌阴性患者相比，幽门螺杆菌感染组明显更年轻（平均47.6岁对62.5岁），男性占优势（51例中的49例对22例中的14例），NSAIDs摄入量明显更少（51例中的3例对22例中的10例），消化不良持续时间更长（51例中的40例对22例中的10例）。幽门螺杆菌感染可能在非NSAID引起的十二指肠溃疡穿孔的病因中起重要作用。根除该细菌是否能缓解该亚组患者强烈的溃疡素质尚不清楚。
