Kim N, Lim S H, Lee K H, Jung H C, Song I S, Kim C Y
Department of Internal Medicine, Kangnam General Hospital, Public Corporation, Seoul, Korea.
J Clin Gastroenterol. 1998 Dec;27(4):321-6. doi: 10.1097/00004836-199812000-00008.
In the short term, the eradication of Helicobacter pylori in patients with duodenal ulcer (DU) is deemed to be clearly effective; the long-term effectiveness apparently depends on the H. pylori reinfection rate. We conducted the present study to investigate the rates of H. pylori reinfection and DU recurrence in 45 patients previously cured of DU in whom H. pylori had been eradicated. These patients underwent gastroscopy and tests for H. pylori at least 1 year after eradication. In a control group comprising 31 patients with DU who were not treated with H. pylori eradication regimen, the DU recurrence rate was checked annually for 4 years. Twenty of 45 patients (44.4%) in whom the mean follow-up period was 3.5 years were again found to be H. pylori positive, and the reinfection rate was 12.8% per year. DU recurred in 8 of these 20 (40%) but not in any nonreinfected patients. In the control group, the DU recurrence rate was 61% within 1 year, 81% within 2 years, 84% within 3 years, and 90% within 4 years. The respective recurrence rates in the 45 patients in whom the bacteria had been eradicated were 0%, 4%, 13%, and 18%. The H. pylori reinfection rate was as high as 12.8% per year in Korea, but in that the DU recurrence rate is significantly lower (p < 0.01; odds ratio, 129.5) in the H. pylori-eradicated group than in the control group, the eradication of H. pylori in DU patients is effective over the long term (at least 4 years).
短期内，根除十二指肠溃疡（DU）患者的幽门螺杆菌被认为疗效显著；长期疗效显然取决于幽门螺杆菌的再感染率。我们开展了本研究，以调查45例先前已治愈DU且幽门螺杆菌已被根除的患者的幽门螺杆菌再感染率和DU复发率。这些患者在根除幽门螺杆菌后至少1年接受了胃镜检查和幽门螺杆菌检测。在一个由31例未接受幽门螺杆菌根除治疗方案的DU患者组成的对照组中，连续4年每年检查DU复发率。45例患者中，平均随访期为3.5年，有20例（44.4%）再次被发现幽门螺杆菌呈阳性，每年的再感染率为12.8%。这20例患者中有8例（40%）DU复发，但未再感染的患者中无1例复发。在对照组中，1年内DU复发率为61%，2年内为81%，3年内为84%，4年内为90%。45例已根除幽门螺杆菌的患者中，相应的复发率分别为0%、4%、13%和18%。在韩国，幽门螺杆菌每年的再感染率高达12.8%，但由于根除幽门螺杆菌组的DU复发率显著低于对照组（p<0.01；比值比，129.5），因此对DU患者根除幽门螺杆菌长期（至少4年）有效。
