The relationship between Helicobacter pylori infection and acid-hematuria syndrome in pediatric patients with gastric augmentation-II

BACKGROUND/PURPOSE: The acid-hematuria syndrome, which presents with dysuria, hematuria, and perineal pain still remains a problem in those patients who have undergone bladder augmentation using the gastrocystoplasty technique. Additionally, there is still a question regarding the explanation for postoperative metabolic problems such as metabolic alkalosis, hypocholoremia, hypergastrinemia, and various complications related to gastritis and peptic ulcer disease. The aim of this study was to investigate the relation of Helicobacter pylori (HP) infection in this patient group and the relationship between HP infection and the above-mentioned clinical problems and complications. METHODS: In this study, 10 children with a history of previous gastrocystoplasty (five girls, five boys; mean age, 6.75+/-2.53 years; range, 2.5 to 12 years) were evaluated. Blood samples for HP detection were analyzed by serological testing (ELISA technique). Histopathologic studies were performed for gastric tissue specimens, obtained by endoscopic procedures from the stomach and augmented bladder. Urine pH and serum gastrin levels were measured in all patients. RESULTS: Regarding the serological studies, four of ten patients had a positive ELISA test result (40%). The four patients with HP-positive serological test results, were the patients who had acid-hematuria syndrome. These patients also had low urine pH levels (mean, 4.5) when compared with those of HP-negative patients. HP-positive patients also had high serum gastrin levels in comparison with those of HP-negative patients. CONCLUSIONS: The relation between HP infection and problems such as hypergastrinemia, acid output, and ulcer disease is well known. Our study demonstrates a correlation between the HP-positive gastrocystoplasty patients and the above-mentioned symptoms and complications. Because of the potential risk of HP infection, we suggest that HP infection be investigated in patients with gastrocystoplasty or in candidates for a gastrocystoplasty operation. HP-positive patients should be treated, to reduce the risks of postoperative complications.     

Empiric treatment based on Helicobacter pylori serology cannot substitute for early endoscopy in the management of dyspeptic rural black Africans.

BACKGROUND: Evidence that chronic gastric Helicobacter pylori (HP) infection is an aetiological factor in dyspepsia, peptic ulcer disease, gastric carcinoma and lymphoma has led to the suggestion that all serologically positive dyspeptic patients should be treated empirically with antibiotics to eradicate the infection, without endoscopic diagnosis. The following study was performed to determine whether such a policy would prove to be of benefit in rural Africa, where endoscopic facilities are lacking and infection rates high. METHODS: Four district clinics were visited and 97 consecutive patients with persistent upper gastro-intestinal symptoms studied. After history-taking and physical examination, a blood sample was taken for HP serology (IgG anti-HP EIA) and endoscopy was performed. RESULTS: In comparison with similar studies in westernised countries HP was considerably more common (80%), and similar to that reported for the background population (83-86%), but peptic ulceration (17%) and gastric cancer (1%) were not. HP status and antibody levels failed to predict the presence of serious disease; patients with 'alarm' signs (78%), cancer (78%) and peptic ulcers (81%) had similar seropositivity rates to patients with non-ulcer dyspepsia (81%). Interestingly, many patients with distal oesophagitis were seronegative (40%). Haemoglobin concentrations and nutritional status were similar in HP-positive and negative patients. On the basis of published decision analysis strategies, empiric treatment of HP-positive patients with uncomplicated dyspepsia could be expected to produce symptomatic relief in 50% of cases, but would have delayed the diagnosis of 3 cases of cancer if patients over the age of 45 were included. CONCLUSION: The lack of association between HP serology and upper gastro-intestinal disease indicates that serological investigation cannot substitute for endoscopy in the management of black Africans with dyspepsia, and that empiric anti-HP therapy cannot be justified.     

Effects of rabeprazole or famotidine during cardiac surgery on perioperative gastric and esophageal pH readings

Objectives: Upper gastrointestinal bleeding, particularly from a stress-induced duodenal ulcer, is an extremely important perioperative complication in cardiovascular surgery. Methods: In the present study, 33 patients undergoing elective open heart surgery between July 2000 and February 2001 were allocated to either a famotidine (FAM) or rabeprazole (RPZ) group to examine the perioperative gastric and esophageal pH readings, in conjunction with an investigation into the effect of infection with Helicobacter pylori (HP). Results: Postoperative upper gastrointestinal bleeding did not occur in either group, and the intraoperative and postoperative mean gastric pH readings, as well as the holding time pH> 6, suggested sufficient acid suppression by either drug. Gastric acid secretion was less strongly suppressed in HP-negative patients in the FAM group, but was unaffected by HP infection status in the RPZ group. Conclusion: The FAM group and RPZ group revealed a sufficient effect of gastric acid suppression. It was indicated that FAM had an insufficient effect of gastric acid suppression for HP-negative patients.     

Effects of rabeprazole or famotidine during cardiac surgery on perioperative gastric and esophageal pH readings

Objectives: Upper gastrointestinal bleeding, particularly from a stress-induced duodenal ulcer, is an extremely important perioperative complication in cardiovascular surgery. Methods: In the present study, 33 patients undergoing elective open heart surgery between July 2000 and February 2001 were allocated to either a famotidine (FAM) or rabeprazole (RPZ) group to examine the perioperative gastric and esophageal pH readings, in conjunction with an investigation into the effect of infection with Helicobacter pylori (HP). Results: Postoperative upper gastrointestinal bleeding did not occur in either group, and the intraoperative and postoperative mean gastric pH readings, as well as the holding time pH> 6, suggested sufficient acid suppression by either drug. Gastric acid secretion was less strongly suppressed in HP-negative patients in the FAM group, but was unaffected by HP infection status in the RPZ group. Conclusion: The FAM group and RPZ group revealed a sufficient effect of gastric acid suppression. It was indicated that FAM had an insufficient effect of gastric acid suppression for HP-negative patients.     

Treatment of peptic ulcer disease in the renal transplant patient.

This study reviews previous reports of peptic ulcer disease in kidney transplant recipients and includes our own experience. Between 1968-1976, 12 transplant centers reported on gastrointestinal complications occurring in 1853 renal transplant recipients. Among these are 52 patients in whom peptic ulcers developed before trnasplantation and 72 patients in whom peptic ulcers developed after transplantation. Included are 21 patients with peptic ulcer from 115 renal transplant recipients at VA Wadsworth Hospital. Patients who were operated upon for peptic ulcer before trnasplant were compared to patients with peptic ulcer before transplant but who were not operated upon. Ulcer recurrence was significantly lower in the operated group p less than .0003. Following transplantation 59 of 68 patients with peptic ulcer disease presented with bleeding or perforation. Mortality was high: 31 deaths in 72 patients (43%). Symptoms usually occurred early, 74% in 6 months, but 19% occurred after one year. The mortality from duodenal, gastric, combined gastric and duodenal and recurrent ulcers did not differ significantly. Elective surgery is indicated for peptic ulcer when demonstrated before or after kidney transplantation.     

Prevalence of Helicobacter pylori infection in bariatric patients: a histologic assessment

BackgroundStudies on rates of Helicobacter pylori (HP) infection in morbidly obese patients awaiting bariatric surgery are conflicting because of small sample size and variability in diagnostic testing. The objective of this study was to determine the rate of biopsy-proven active HP infection in morbidly obese patients undergoing bariatric surgery.MethodsRetrospective analysis was done on all morbidly obese patients who underwent bariatric surgery between 2001 and 2009. All patients underwent preoperative upper endoscopy with biopsy to evaluate HP status. All endoscopies and surgeries were performed by a single endoscopist and surgeon, respectively. Data were analyzed with Student t test, Pearson χ² test, and logistic regression for multivariate analysis.ResultsThe 611 patients included 79 males (12.9%) and 532 females (87.1%). Mean age was 39.9±10.7 years, and mean body mass index (BMI) was 47.8±6.4 kg/m². The overall HP infection rate was 23.7%. Rate of infection did not differ between gender (22.8% in males, 23.9% in females; P = .479) or BMI (48.6±6.5 kg/m² in HP-positive patients, 47.5 ± 6.4 kg/m² in HP-negative patients; P = .087). Patients with HP were older compared with those without infection (41.2 versus 38.7 years; P =.016). Hispanics had a higher prevalence of HP (OR 2.35; P = .023).ConclusionIncreasing BMI is not an independent risk factor for active HP infection within the morbidly obese patient population. Need for invasive testing to detect HP infection in these patients should be re-evaluated. Other methods of detecting active HP infection should be considered as an alternative to invasive or serologic testing.     

Helicobacter pylori colonization in surgical patients]

The prevalence of Helicobacter pylori (HP) was examined in 387 patients undergoing endoscopy of the upper gastrointestinal tract. Of central interest was the question to which extent surgical intervention influences the colonisation of the gastric mucosa with HP. The bacillic status was appraised using double microbiological examinations, histological determination and the CLO-test. In 229 patients a 13C-urea-breath test was also carried out (sensitivity 98%). HP could be detected in 90% of all patients presenting with duodenal ulcers as well as in 70% of patients with gastric ulcers, whereas in those patients in whom a lesion of the upper gastrointestinal tract could be excluded through endoscopy. HP was found in only 27%. The prevalence of HP did not increase with age. In patients having undergone distal gastric resection due to gastric ulcers, HP was only rarely found (19%) in the mucosa in the vicinity of the anastomosis following removal of the apparently pathogenetically important antrum mucosa. There was no association between anastomosis ulcers and bacillic colonisation. Following selective proximal vagotomy in patients with duodenal ulcers, HP was found in 80% of all cases. In these patients there was also no association between recurrent ulceration and a HP-positive status. Our results describe the postoperative HP-status after different surgical procedures of ulcer therapy: whereas a distal gastric resection removes the antrum mucosa, which provides the necessary environmental milieu, the HP-colonisation rate after selective proximal vagotomy is similar to that in non-operated ulcer disease.     

Characteristics of Helicobacter infections in gastroduodenal ulcers and their complications]

The presence of Helicobacter pylori (HP) was studied in 143 patients with ulcer disease of the stomach and duodenum. The urease test, immunoenzyme analysis, "AEROTEST" and culture of HP in laboratory conditions were used for diagnosis of HP. On the grounds of the culture method three degrees of colonization of the gastroduodenal mucosa were established. It was found that 96.3% of the patients were infected with HP, 86.3% of them having massive colonization. All the patients with complicated ulcers of the duodenum were HP-positive. A severe degree of the HP-infection with the predominant involvement of the antral part was characteristic of patients with bleeding ulcers; in patients with perforative ulcers and stenosis of the pyloric part the HP status is notable for considerably greater variability. Among the patients with gastric ulcers there was less amount of cases with HP (88.2%) as compared with those having duodenal ulcers. All patients with complicated disease were infected with HP, but there was nothing specific in colonization depending on.     

Gastro-duodenal lesions and Helicobacter pylori infection in uremic patients and renal transplant recipients

BACKGROUND: Upper gastrointestinal (UGI) symptoms are common in uremic patients, and higher serum levels of urea have been suggested to be related to Helicobacter pylori (HP) colonization and UGI mucosal inflammation. AIM: The aim of this study was to compare HP infection and UGI endoscopic findings between uremic patients, renal transplant (RT) recipients, and controls. METHODS: A total of 474 subjects (71 chronic renal failure [CRF], 73 hemodialysis [HD], 25 Tx, and 305 controls) from Baqyiatallah Hospital, Tehran, Iran were recruited between April 2002 and March 2004 for evaluation of dyspepsia, excluding those receiving any HP-eradication therapy. All subjects were examined for esophagus, stomach and duodenum mucosa, and infection with HP on 2 distinct tissue samples of the anthral region. RESULTS: Four groups of subjects (mean +/- 2 se; age, 45 +/- 1.6 years; 62.9% male) were studied. Duodenal ulcer in the uremic patients (CRF, 16.1%; HD, 13.7%) was more common than that in the RT-recipients (8%) and controls (6.5%); P=.038. Erosive gastritis and duodenal bulb deformity were also more common in the uremic subjects (CRF, 23.9%, 36.9%; HD, 30.1%, 20.5%, respectively) than those in the other subjects (RT recipients, 16%, 8%; controls, 8.2%; 0%, respectively); P<.001. HP infection was found to be higher in the uremic patients (CRF, 66.2%; HD, 63%) than in the RT recipients (40%) and controls (34.8%); P<.001. CONCLUSION: Higher rates of gastric and duodenal mucosal lesions and HP infection in the uremic patients in comparison with the subjects with normal renal function may have resulted from higher serum levels of urea, anemia, and fluctuations in the gastric blood supply in the CRF and HD patients. However, more tenable evidence from controlled trials is required for the eradication of HP in all uremic patients and transplantation candidates.     

Preoperative Work-up in Asymptomatic Patients Undergoing Roux-en-Y Gastric Bypass: Is Endoscopy Mandatory?

Background: We aimed to determine before Roux-en-Y gastric bypass (RYGBP) in asymptomatic morbidly obese patients: 1) the prevalence of abnormal findings at upper gastrointestinal (UGI) endoscopy; 2) Helicobacter pylori (HP) status; 3) clinical consequences of these findings; and 4) associated costs. Methods: We retrospectively reviewed 468 consecutive patients, excluded those with UGI symptoms, drug intake or previous UGI endoscopy/surgery, and analyzed findings in the 319 remaining patients (68%). Results: There were abnormal findings in 147 patients (46%), including 54 hiatal hernias and 146 parietal (i.e. mucosal or submucosal) lesions. The most significant were 7 ulcers and 2 gastric polyposis. HP was detected (using CLO-test) in 124 patients (39%). Histopathological examination of biopsies was abnormal in 109/161 patients (68%), and disclosed mainly chronic gastritis (n=98). Abnormal findings were more frequent in HP-positive compared to HP-negative patients (94 vs 51%, P<0.001). Findings had clinical implications in only 4% of patients: delayed surgery (7 ulcers), prophylactic gastrectomy (2 gastric polyposis), unnecessary work-up (3 irrelevant/false-positive diagnoses), and inclusion in a screening program (1 Barrett's esophagus). Mean cost of complete UGI work-up was 389 €/patient. Conclusion: Asymptomatic morbidly obese patients frequently harbour UGI lesions warranting UGI work-up before RYGBP. However, routine endoscopy presents drawbacks. We propose a less invasive strategy which reduces costs and limits false-positive results and the subsequent investigations that they require. In our series, it would have missed two gastric polyposis only, for which no formal recommendation has yet been issued. This strategy could be a valuable alternative to routine UGI endoscopy before RYGBP in asymptomatic patients.     

Photoeradication of Helicobacter pylori using 5-aminolevulinic acid: preliminary human studies

BACKGROUND AND OBJECTIVES: Helicobacter pylori (HP) is an endemic pathogenic bacterium causing gastritis and gastroduodenal ulceration in humans and is linked to the development of gastric malignancies. These first human in vivo studies investigated the photoeradication of HP using laser and white light. STUDY DESIGN/MATERIALS AND METHODS: In 13 HP-positive volunteers, a zone of gastric antrum was irradiated with laser (410 nm, 50 J/cm(2)) or endoscopic white light (10 J/cm(2)) 45 minutes after oral 5-aminolevulinic acid (5-ALA) 20 mg/kg. HP-eradication was assessed by biopsy urease test and HP-culture from irradiated and control zones 5 minutes, 4 and 48 hours post-irradiation. RESULTS: A maximum eradication effect was achieved at 4 hours post-irradiation when 85% of biopsies in the monochromatic and 66% in the white light exposed zones, and 58 and 33% in the respective control zones were HP-negative. CONCLUSIONS: HP numbers were greatly reduced following exposure to 5-ALA and either laser or white light in vivo. Photoeradication appears feasible, but further light dosimetry and the development of convenient application methods is required.     

Treatment of perforated gastroduodenal ulcer by simple suture followed by Helicobacter pylori eradication

AIMS OF THE STUDY: To determine the prevalence of Helicobacter pylori (HP) infection in Vietnam in case of perforated gastro-duodenal ulcer and to evaluate efficiency of medical treatment to obtain eradication of HP and ulcer healing. PATIENTS AND METHODS: One hundred and eleven patients with perforated gastro-duodenal ulcer underwent surgical suture. HP infection was diagnosed by urease test and pathologic examination of peroperative antral biopsies, and by postoperative detection of HP-specific immunoglobulins G. HP infection was defined by positivity of at least one test. Medical treatment included omeprazole, clarithromycin, and amoxicillin for 7 days followed by omeprazole for 3 weeks for duodenal ulcer and 5 weeks for gastric ulcer. Follow-up endoscopy with biopsies was performed 4 to 6 weeks after treatment cessation. RESULTS: Among 111 patients, 107 (96%) were infected by HP. The 4 patients non-infected by HP were treated by omeprazole alone and excluded from the study. Ulcer healed in 99 patients (93%). HP eradication was obtained in 102 patients (95%). The 8 patients with a non-healed ulcer and the 5 patients in whom HP eradication was not obtained at the first endoscopic control received additional medical treatment. Ultimately HP eradication and ulcer healing were obtained in all cases. CONCLUSION: In a country in which prevalence of HP infection is high, acid-reduction surgery is unnecessary in case of perforated gastro-duodenal ulcer treated by simple surgical closure.     

Outcome of living kidney transplant: pediatric in comparison to adults

BACKGROUND: Renal transplantation is the most optimal way to manage children with end-stage renal disease. Despite its benefits, pediatric renal transplantation is a challenge for several transplantation centers in terms of achieving a satisfactory outcome. We sought to compare the long-term outcome of pediatric versus adult recipients who underwent renal transplantation. METHOD: We examined, 2631 recipients of a first kidney from a living donor between 1982 and 2002. The two groups were matched for immunosuppressive therapy and number of HLA mismatches. The patients were divided into a pediatric (n=301; age 18 years) to compare 5-year patient and graft survivals. RESULTS: The mean ages of the pediatric and adult groups were 40 +/- 13 and 14 +/- 13 years, respectively. The 5-year graft survival was lower among the pediatric versus the adult group (56% vs 68%; P=.015) with no difference in patient survival (88% vs 86%; P>.05). CONCLUSION: The poorer graft survival in pediatric transplantation may be due to the nature of pediatric transplantation, in terms of inconsistent adherence to medication regimens, worse side effects of medications, higher rate of graft rejection due to recurrent disease, and more intense immunoreactivity of children.     

血液透析患者幽门螺杆菌感染现状调查及危险因素分析

目的:研究维持性血液透析患者幽门螺杆菌(HP)的感染率并分析感染相关危险因素。方法:采用横断面调查研究方法选取2018年8月本院肾内科的190例血液透析患者为研究对象,选取同期本院体检中心健康体检人群18 375例为对照组,分析血液透析患者与健康人群HP感染率的差别。然后根据是否感染HP,将血液透析患者分为HP阴性组(...     

Cystic fibrosis,gastroduodenal inflammation,duodenal ulcer,and H. pylori infection: The “cystic fibrosis paradox” revisited

BackgroundIn cystic fibrosis (CF) patients a duodenal impaired bicarbonate secretion and unbuffered gastric acid are always described and the development of duodenal ulceration is uncommon (CF paradox). Helicobacter pylori (HP) infection is the main cause for duodenal ulceration and its prevalence in CF patients is controversial.AimThe objective of this study is to evaluate HP prevalence, gastric histology, and duodenal ulceration in adult FC patients.Methods32 adult CF patients were submitted to ¹³C-urea breath test and serum immunoblotting test for HP diagnosis. Among them, 20 patients were submitted to endoscopy.Results19/32 (68%) patients showed positive serology. Endoscopy showed erosive duodenitis (15%), and duodenal ulcer scar in 10%. On duodenal histology, 94.5%, showed active inflammation and 66.7% gastric metaplasia.ConclusionHP infection prevalence in adult CF patients was similar to that of general Brazilian population. CF patients have all the duodenal spectrum of alterations, including duodenal ulcer. CF paradox may not exist.     

Cytomegalovirus disease after kidney transplantation: clues to accurate diagnosis

BACKGROUND: The clinical diagnosis of cytomegalovirus (CMV) disease after kidney transplantation is often not accurate. We evaluated the factors associated with a correct diagnosis of CMV disease in these patients. MATERIALS AND METHODS: This retrospective study of all renal transplant patients between 2004 and 2005 with a clinical diagnosis of CMV disease included both donors and recipients who were seropositive for CMV at transplantation. We assessed the rate and correlated factors with a correct diagnosis. RESULTS: Among 127 cases, the 30 (23.6%) patients who had a correct diagnosis of CMV disease. Showed higher ages at transplantation (48.8 +/- 15.3 vs. 39.8 +/- 14.4 years; P=.004) and a shorter interval between transplantation and symptom presentation (9.7 +/- 20.7 vs. 25.6 +/- 33.6 days; P=.048). Diabetes mellitus (DM) was the cause of end-stage renal disease (ESRD) in 41% of patients with a correct diagnosis, whereas it was the cause in 11% of CMV disease-negative patients (P<.001). A multiple logistic regression model showed that DM as the cause of ESRD (P=.001; odds ratio [OR] 16.331), >5 months duration between transplantation and the presence of symptoms (P=.001; OR, 0.060), and age at transplantation >55 years (P=.022; OR, 3.833) were predictors of a correct diagnosis of CMV disease (chi(2)=46.45; P<.001). CONCLUSION: The results herein showed that considering some variables significantly improved the accuracy of a correct diagnosis of CMV disease after kidney transplantation.     

Bile acid inhibits tetragastrin-stimulated gastric secretion after Roux-en-Y biliary diversion in dogs

The present study was carried out to investigate the effect of several bile acids on tetragastrin-stimulated gastric secretion in dogs in which diversion of the biliary system was performed. Cholecystojejunostomy of the Roux-en-Y type was performed, along with the creation of a Heidenhain pouch (HP) and an external duodenal fistula. Gastric juice was collected from the HP and a mixture of bile acids and corn oil was administered through the duodenal fistula. Ursodeoxycholic acid (UDCA) and chenodeoxycholic acid (CDCA) exerted an inhibitory effect on gastric hypersecretion. Conjugated UDCA and several bile acids with different hydroxyl groups were also examined, and these bile acids also showed evidence of an inhibitory effect on the secretion of gastric juice, although there were no significant differences between them. Thus, it appears that all bile acids inhibit tetragastrin-stimulated gastric hypersecretion. This finding suggests that peptic ulcer disease can be prevented by the administration of bile acids to patients who undergo biliary diversion and are at a high risk for this postoperative complication.     

Risk factors for peptic ulcer disease in renal transplant patients--11 years of experience from a single center

BACKGROUND: Peptic ulcer disease is a common complication among renal transplant recipients and causes significant morbidity and mortality. METHODS: From 1990 through 2000, 465 renal transplant patients were followed-up in our institute. Most patients received corticosteroids and cyclosporine-based immunosuppressive regimen. About one third (n = 156) of them received mycophenolate mofetil. Patients with endoscopy-proved peptic ulcer disease were identified by reviewing medical records. Possible risk factors were analyzed by univariate analysis and multiple logistic regression analysis. RESULTS: Among 465 kidney transplant patients, there were 181 (38.9%) who suffered at least 1 episode of peptic ulcer disease. The most frequent types of peptic ulcer disease were gastritis, gastric ulcer, duodenal ulcer, esophagitis, duodenitis and esophageal ulcer. By multivariate analysis, the use of methylprednisolone pulse therapy (odds ratio = 3.954, 95% confidence interval = 3.154-18.312, p = 0.03) and history of pre-transplant peptic ulcer disease (odds ratio = 7.599, 95% CI = 1.211-12.905, p < 0.0001) were independent risk factors for posttransplant peptic ulcer disease. CONCLUSIONS: Our findings demonstrated that renal transplant patients who undergo methylprednisolone pulse therapy for acute rejection or who have a history of pre-transplant peptic ulcer disease carry a high risk for the development of peptic ulcer disease and deserve intensive antiulcer treatment.     

Causes of rehospitalization after renal transplantation; does age of recipient matter?

BACKGROUND: This study assessed the causes and related factors of rehospitalization following renal transplantation among elderly compared with younger patients. METHODS: We reviewed the charts of 567 patients rehospitalized after kidney transplantation from 2000 to 2006. According to age at the time of transplantation, hospitalizations were divided into two groups: group 1 (age >or=50 years) and group II (age 20 to 50 years). Demographics, clinical findings, causes for rehospitalization, patient outcomes (recovery, graft loss, death), intensive care unit (ICU) admission, length of hospital stay, time interval from transplantation to rehospitalization, as well as hospital costs were compared between the two groups. RESULTS: One hundred eighty-five (32.6%) rehospitalizations were charted for group I, who showed a higher proportion of admissions due to infection (42.2% vs 29.8%, P=.004) and macrovascular disease (3.8% vs 1.0%, P=.027) compared with group II. ICU admission (8.8% vs 2.4%, P=.001), mortality (10.2% vs 3.6%, P=.008), and hospital charges (1610 +/- 933 vs 931 +/- 850 purchase power parity dollars, P=.001) were also seen more frequently in group I but displayed a lower frequency of admissions due to graft rejection (20% vs 34.3%, P=.001). CONCLUSION: Recipient age at the time of transplantation was a main factor affecting rehospitalization among our patients.     

反流性食管炎的临床流行病学调查

目的:分析反流性食管炎的临床流行病学特点.方法:我院1999年5月-2003年3月经胃镜检查诊断为反流性食管炎患者288例,分析其发病率及年龄分布、伴发疾病、幽门螺杆菌感染率,并与同期其他疾病的幽门螺杆菌感染率相对照.结果:反流性食管炎的发病率为4%,男女比例为3.6:1,发病年龄以中年为主,平均年龄为47岁.反流性食管炎的幽门螺杆菌感染率为25.0%,明显低于胃溃疡、十二指肠球部溃疡和萎缩性胃炎(P＜0.01),主要伴发疾病为十二指肠溃疡、萎缩性胃炎和食管裂孔疝.内镜下反流性食管炎以轻度(Ⅰ型)居多,65.6%.结论:我们的研究提示,反流性食管炎患者以轻型为主,防治重点入群应为中、老年男性;幽门螺杆菌在反流性食管炎有较低的感染率;反流性食管炎主要伴发疾病为十二指肠溃疡、萎缩性胃炎和食管裂孔疝.