幽门螺杆菌与非甾体抗炎药致消化性溃疡治疗分析

目的研究根除幽门螺杆菌（HP）对长期服用非甾体抗炎药（NSAID）所致的消化性溃疡愈合和复发的影响。方法将116例长期服用NSAID所致的消化性溃疡患者分为HP阳性奥美拉唑组43例,HP阳性奥美拉唑加阿莫西林组38例,HP阴性奥美拉唑组35例,三组的用药时间均为6周。结果三组溃疡愈合率依次为65%、74%、71%（P〉0.05）。追踪溃疡愈合者87例,并分为HP根除组26例,HP持续阳性组32例,HP持续阴性组29例。均停用抗溃疡药物,继续服用NSAID6个月后复查。累计溃疡复发率三组分别为31%、44%、29%（P〉0.05）。结论根除HP不能提高NSAID相关消化性溃疡的愈合率,亦不能降低其复发率,且HP持续阳性者其溃疡复发率有升高趋势。

Eradicating helicobacter pylori on healing and recurrence of peptic ulcer caused by nonsteroial antiinflammatory drug

Objective To study the influence of eradicating helicobacter pylori（HP） on healing and recurrence of peptic ulcer cases with long-term use of nonsteroial antiinflammatory drug（NSAID）.Methods 116 peptic ulcer cases taking long-term NSAID were divided into omeprazole group of Hp positive reaction（n = 43,omeprazole 20mg,two times a day）,omeprazole plus amoxicillin group of Hp positive reaction（n = 38,omeprazole 20mg,two times a day;amoxicillin 0.5g,three times a day） and omeprazole group of Hp negative reaction（n =35,omeprazole 20mg,two times a day）.Results Ulcer healing rates in three groups were 65%,74%,71% respectively（P 0.05）.87 healed cases were divided into the eradicated Hp group（n = 26）,HP lasting positive reaction group（n = 32） and Hp lasting negative reaction group（n = 29）,and all the healed cases stopped peptic ulcer drug,but NSAID was taken continuously.73 cases were checked in 6 months,and u1cer recurrence rates in three healed groups were 31%,44%,29%,respectively（p 0.05）.Conclusion Eradicating Hp can neither improve the ulcer healing rates nor reduce the recurrence rates.But the ulcer recurrence rates of Hp lasting position reaction show a tendency to increase.