根除幽门螺杆菌对慢性糜烂性胃炎自然病程影响的2年随访研究

目的　探讨根除幽门螺杆菌 (Hp)对慢性糜烂性胃炎 (CEG)自然病程的影响。 方法　选择胃镜证实的CEG病人92例 ,均有Hp感染 (胃粘膜Giemsa染色和14 C 尿素呼吸试验二项均阳性 )。予奥美拉唑 2 0mg ,bid ;羟氨苄青霉素75 0mg ,bid ;甲硝唑 40 0mg ,tid ,疗程 2周。疗程结束后 4周复查胃镜和Hp ,糜烂愈合者分为A组 (Hp根除组 )和B组 (Hp未根除组 )进入随访阶段 ,随访观察 2年。结果　糜烂愈合 83例 ( 90 .2 % ) ,Hp根除 75例 ( 81.5 % ) ;Hp根除的糜烂愈合率 90 .7% ( 68/ 75 )与Hp未根除的愈合率 88.2 % ( 15 / 17)差异无显著性 (P >0 .0 5 ) ;A组第 1、2年糜烂复发率分别为 10 .4%和 3 0 .8% ,均显著低于B组的 66.7%和 86.7% (P <0 .0 0 5 )。结论　根除Hp并不能提高CEG的愈合率 ,但可显著减少其复发率。根除Hp有可能改变CEG的自然病程。

Influence of Eradication of Helicobacter Pylori on the Natural Progress of Chronic Erosive Gastritis over a 2-Year Follow-up Period

Objective To investigate whether the eradication of Helicobacter pylori(Hp) has any influence on the natural progress of chronic erosive gastritis.Method Ninety two patients with chronic erosive gastritis proved by endoscopy,with a positive 14 C urea breath test and confirmed presence of Hp by Giemsa staining in gastric biopsy speciments,were enrolled into the study.Anti Hp therapy with omeprazole(20mg,bid) plus amoxycillin(750mg,bid) plus metronidazole(400mg,tid) was administered for 2 weeks.Endoscopy was performed 4 weeks after antimicrobial therapy ended,and the presence or absence of Hp was determinated by the above tests.Then,all patients with healed erosion were divided into group A(Hp eradicated) and group B(Hp not eradicated) and were followed up for 2 years.Results Among 92 patients,erosion was healed in 83 cases(90.2%) and Hp eradicated in 75 cases(81.5%).There was not significant difference between two groups in erosion healing rates( P >0.05).The erosion recurrence rates during the first year and the second year in group A(10.4% and 30.8%,respectively) were significantly lower than those in group B(66.7% and 86.7%,respectively, P <0.05).Conclusions Eradication of Hp can not increase the healing rate of CEG but can reduce the recurrence rate.Our finding suggestes that eradication of Hp might significantly change the natural progress of chronic erosive gastritis.