HP与消化性溃疡

许多资料证实,ＨＰ与消化性溃疡的发生、发展及复发密切相关。据报道,ＨＰ在十二指肠溃疡患者中检出率为８０％～１００％,在胃溃疡中的检出率为５９％～８６％。ＨＰ检出率的不同,除与诊断方法不同有关外,亦表明不同国家和地区的ＨＰ感染率有异。１．ＨＰ在消化性溃...     

消化性溃疡出血相关因素的分析

目的 探讨幽门螺旋杆菌及其他因素同消化性溃疡出血的相关性。方法 胃镜确诊的消化性溃疡92例,分为两组:单纯消化性溃疡组和出血组,系统收集临床资料,并进行如下检测:胃黏膜快速尿素酶检测、病理HE染色检查、13C呼气试验检测和血清Helicobacter pylori抗体和CagA抗体的检测。结果NSAIDs药物同出血相关,OR值为7.61(P<0.05)。出血组和非出血组之间H.pylori感染率分别为68.1％和60.6％,两组之间无显著性差异,但出血组血清CagA抗体阳性率高于非出血组(分别为61.2％和37.5％),OR值为2.63,范围为1.05～6.59,P<0.05。结论 服用NSAIDs药物和CagA抗体阳性与出血密切相关,出血组和非出血组之间H.pylori感染率无显著性差异。     

pH、HP与消化性溃疡

ｐＨ、ＨＰ与消化性溃疡宋世良（江苏省太仓市第一人民医院太仓２１５４００）ｐＨ是酸碱度的代号。关于酸与溃疡的关系，早在１９１０年Ｓｃｈｗａｒｚ就指出：＂Ｎｏａｃｉｄ，ｎｏｕｌｃｅｒ＂，即＂没有酸就没有溃疡＂。这一医学名言一直沿用了近一个世纪，至今仍有其...     

消化性溃疡胃镜分析和流行病学分析

为探讨昆明地区消化性溃疡 (ｐｅｐｔｉｃｕｌｃｅｒ,ＰＵ)的流行病学现况及临床意义 ,我们分析了 8398例ＰＵ患者发病与性别、年龄、季节、部位、并发症的关系 ,并进行了胃镜和流行病学分析 ,现将结果报告如下。一、对象与方法1.对象 :病例来源于我院 1973年 12月至 2 0 0 0年 12月间经胃镜检查确诊为ＰＵ的 8398例患者 ,男 6 4 77例 ,女192 1例 ,年龄 16～ 75岁 ,平均年龄 4 4 .3岁。2 .方法 :应用流行病学的方法 ,按月逐年统计登记册中的胃镜检查人数及ＰＵ检出数 ,分别对检出率、性别、年龄、季节、部位和并发症进行胃镜和流行病学分析…     

糖尿病合并消化性溃疡80例临床分析

目的探讨糖尿病合并消化性溃疡的临床特点,并与非糖尿病性消化性溃疡进行比对分析。方法针对该院从2011年4月—2014年4月收治的80例糖尿病合并消化性溃疡患者作为研究对象。取同期的非糖尿病性消化性溃疡作为对照,两组患者均进行临床症状、Hp感染率、胃镜特点的比较。结果两组患者在临床症状、Hp感染率、胃镜特点和Hp根除率的表现上差异均具有统计学意义(P0.05)。结论糖尿病合并消化性溃疡有其自身的特点,和非糖尿病消化性溃疡症状有差异,可以通过胃镜检查作为区分手段,针对Hp感染的患者,通过延长治疗时间可以提升根治率。     

1386例消化性溃疡的流行病学分析

我院１９８１年１月至１９９７年１２月共进行胃镜检查９０６３例 ,检出消化性溃疡（ＰＵ）１３８６例 ,总结分析如下 ,以便为临床防治提供一些有益的资料。１．ＰＵ的检出情况 :在接受胃镜检查的９０６３病例中 ,共检出ＰＵ１３８６例 ,检出率为１５．３ %。其中 ,十二指肠溃疡（ＤＵ）９２３例 ,占ＰＵ病例的６６．６ % ,胃溃疡（ＧＵ）４２７例 ,占３０．８ % ,复合性溃疡（ＣＵ）３６例 ,占２．６ %。２．ＰＵ的部位分布 :ＤＵ中 ,病变部位依次为球前壁５０３例 ,占５４．５ % ;球大弯１６９例 ,占１８．３ % ;球小弯１４３例 ,占１５．…     

老年消化性溃疡与幽门螺杆菌感染的关系

由于老年人的生理特点和环境因素的影响,老年消化性溃疡有许多特点。我们对我院2001年3月~2005年6月收治的200例老年消化性溃疡患者的临床资料进行分析,以了解老年消化性溃疡与幽门螺杆菌感染的关系。对象与方法1.对象:200例患者中,男性105例,女性95例,平均年龄(70.14±3.08)岁     

老年人消化性溃疡——附146例分析

目的探讨老年消化道溃疡的特点。方法报道146例老年与139例中青年消化性溃疡患。结果老年消化性湖疡具有症状不典型，腹痛少、出血率高、溃疡大，伴随疾病多的特点。此外、老年组幽门螺杆菌（HP)检出率为77.8％，高于中青年组的56％(P<0．05)。结论对老年消化性溃疡的治疗除加强胃牯膜保护及制酸治疗外，抗菌治疗及加强对伴随疾病的治疗也是十分必要的。     

小儿消化性溃疡37例临床分析

小儿消化性溃疡并不罕见,但由于临床症状不典型及在儿科领域纤维内镜尚未普遍应用,故常易误诊,并影响及时治疗。自1990年10月—1993年9月因小儿消化道出血作内镜检查共53例,其中37例为消化性溃疡,报道如下:1 对象和方法1.1 对象 53例小儿消化道出血患者,男性35例,女性18例。发病年龄5—14岁,小于10岁者5例(9.4％),大于10岁者48例(90.6％)。1.2 临床表现 53例患儿中出现呕血和便血者10例(18.     

消化性溃疡与幽门螺杆菌L型感染相关性研究

目的　探讨消化性溃疡 (PU)与幽门螺杆菌 L型 (HP- L )感染的关系。方法　取 386例 PU患者胃窦、胃体及十二指肠粘膜组织 ,常规切片后以革兰氏染色和免疫组化染色镜检 HP- L 型细菌 ,并计算检出率。结果　 HP- L 型检出率为 5 3.37% ,其中革兰氏染色和免疫组化染色检出率分别为 5 6 .73%、5 4 .2 9% ,差异无显著性(P>0 .0 5 ) ;胃溃疡、十二指肠溃疡 HP- L 型检出率分别为 5 8.33%、5 5 .5 0 % ,差异无显著性 (P>0 .0 5 ) ;男女患者HP- L 检出率前者 (6 1.18% )明显高于后者 (38.17% ) (P<0 .0 1) ;30岁以下、30岁～、4 0岁～、5 0岁～患者 HP- L检出率依次为 32 .0 5 %、4 1.94 %、5 9.18%、71.79% ,差异显著 (P<0 .0 1)。结论　 PU患者 Hp- L型感染率较高 ,且男性高于女性 ,HP- L型检出率随年龄增长而增高。 PU患者 HP- L型变异可能是导致溃疡迁延不愈、反复发作的重要原因之一     

幽门螺杆菌与消化性溃疡并出血的研究现状

幽门螺杆菌是消化性溃疡的确定性致病因素,其在溃疡并出血的作用尚不十分明确.目前,幽门螺杆菌在消化性溃疡并出血的感染率受检测方法、药物等影响不尽相同.幽门螺杆菌感染在一定程度上增加了消化性溃疡并出血的危险性,从长远上根除幽门螺杆菌可以降低溃疡出血风险,促进溃疡愈合.     

飞行人员消化性溃疡患病特点分析

目的 分析飞行人员消化性溃疡的患病特点,为其制定有针对性的防治方案提供理论依据.方法 采用回顾性分析方法分析2002年1月-2012年1月在空军总医院住院的26例消化性溃疡的飞行人员患病特点.结果 消化性溃疡的发病年龄有两个高峰期,25 ～29岁患者7例（26.92％）和40～ 44岁患者7例（26.92％）;运输机和战斗机飞行员发病率较高;心理应激因素和幽门螺旋杆菌（H.pylori）是导致飞行人员消化性溃疡的重要致病因素.结论 对于飞行人员来说,紧张、焦虑、恐惧等心理因素是消化性溃疡的主要诱发因素;其次,H.pylori也是造成飞行人员消化性溃疡的另一重要病因.     

雷贝拉唑在消化性溃疡治疗中的作用及其安全性的大规模临床研究

目的观察雷贝拉唑片剂(波利特)单独应用或联合抗幽门螺杆菌(Hp)治疗对消化性溃疡患者主要症状的治疗作用及其安全性。方法在全国24个省市进行多中心、开放试验。经胃镜诊断为消化性溃疡活动期或愈合期的患者由医师根据其具体情况安排单独应用雷贝拉唑(10mg,每天1次,7d)或联合抗Hp治疗(其中雷贝拉唑为10mg,每天2次,每个疗程5d或7d)。观察治疗前(d0)、用药后第1(d1)、2(d2)、5(d5)和7天(d7)的症状,并记录不良反应。结果试验共入选患者25609例,其中包括胃溃疡、十二指肠溃疡、复合性溃疡、食管溃疡、应激性溃疡、吻合口溃疡。Hp总体阳性率为71.0%。单独用雷贝拉唑者11386例,联合用药14223例。在d1、d2、d5和d7,上腹痛的缓解率分别为63.0%、91.2%、99.2%和99.7%;消失率为16.0%、47.8%、80.3%及94.8%。总体症状缓解率分别为66.5%、94.6%、99.7%和99.9%。上述指标在两组之间比较差异均无统计学意义。共发生不良反应476例(1.9%)。单独用药组147例(1.3%),联合用药组329例(2.3%),两组间比较差异有非常显著意义(P<0.01)。多数不良反应轻微。结论雷贝拉唑在单独用药及与抗Hp药物合用时,对消化性溃疡患者的主要症状都具有明显的治疗作用,并具有良好的安全性。     

北京29所医院1999年度消化性溃疡患病情况分析

目的了解北京地区消化性溃疡的发病情况及变化特点。方法回顾性分析北京地区29所医院1999年胃镜检查消化性溃疡的临床资料,并与北京地区前两次统计结果及国内部分城市统计结果相比较。结果在64874例胃镜检查中,检出消化性溃疡8832例,检出率为13.61%。其中十二指肠溃疡6179例,占69.96%;胃溃疡2058例,占23.30%;其他溃疡(包括复合溃疡和吻合口溃疡)595例,占6.74%。三级医院消化性溃疡检出率为13.16%,二级医院为19.11%(P<0.01)。城区医院消化性溃疡检出率13.23%,近郊区医院为13.55%,远郊区医院为20.59%(与前两者相比,P<0.01)。北京市市民消化性溃疡检出率为13.83%,外地来京人口为11.62%(P<0.01)。结论(1)北京地区消化性溃疡患病率呈逐渐下降趋势,特别是十二指肠溃疡,但十二指肠溃疡患者仍明显多于胃溃疡。(2)与国内其他地区相比,北京地区消化性溃疡的发病率低于南方大城市,而高于东北和西北地区;提示自北向南消化性溃疡的发病率呈逐渐升高趋势。     

幽门螺杆菌感染、服用非甾体抗炎药与消化性溃疡的关系

目的 研究消化性溃疡患者由于幽门螺杆菌（H.pylori）感染或服用非甾体抗炎药（NSAIDs）的发生率.方法 选取湖北省武汉市武昌医院2010年3月-2012年7月诊治的152例消化性溃疡患者,将其作为治疗组,同时选取同一时间段到消化科就诊的234例非消化性溃疡患者,将其作为对照组.结果 胃溃疡组感染H.pylori的几率是对照组的2.308倍,十二指肠溃疡组是对照组的8.186倍;胃溃疡组服用NSAIDs的几率是对照组的6.072倍,十二指肠溃疡组是对照组的2.823倍;胃溃疡组同时感染H.pylori和服用NSAIDs的几率是对照组的14.972倍,十二指肠溃疡组是对照组的28.873倍.结论 H.pylori感染同时服用了NSAIDs患者增加消化性溃疡的发生危险性,两种因素同时存在可以起协同作用,增加消化性溃疡的发生几率.     

Epidemiology of Helicobacter pylori and peptic ulcer in India

BACKGROUND: There is a wide variation in the prevalence of peptic ulcer in India both before and since the use of endoscopy. We studied the prevalence of peptic ulcer disease in a community in northern India and its relationship with Helicobacter pylori infection. METHODS: A house-to-house survey of residents aged 15 years or above in a sub-sector of Chandigarh was performed as part of a pilot survey. Subsequently, the study randomly covered all sectors of Chandigarh and we screened 2649 persons. A questionnaire was administered to each subject by trained staff. All individuals with history of peptic ulcer/dyspepsia and an equal number of asymptomatic individuals were asked to attend the outpatient department of the Institute. Diagnosis of peptic ulcer was based on endoscopy or history of previous ulcer surgery. RESULTS: Two hundred and fifty-four individuals attended the outpatient department at the Institute and 147 underwent endoscopy, biopsy for histology and rapid urease test, and blood was collected for H. pylori serology. There were 80 symptomatic and 67 asymptomatic individuals. Helicobacter pylori was positive in 38 (56.7%) asymptomatic and 49 (61.3%) symptomatic individuals (P > 0.05). The point prevalence of active peptic ulcer was 3.4% and the lifetime prevalence was 8.8%. The duodenal-to-gastric ulcer ratio was 12:1. Helicobacter pylori was present in 11/13 (84.6%) subjects with peptic ulcer. Peptic ulcer was more common in elderly and dyspeptic individuals and there was no effect of sex or socioeconomic status. Helicobacter pylori was associated with age only and did not depend on sex, socioeconomic status or dyspepsia. Of the 38 asymptomatic persons having H. pylori infection, none had active peptic ulcer. CONCLUSIONS: This study demonstrates frequent occurrence of peptic ulcer and H. pylori in this part of the country. Peptic ulcer was more prevalent in the elderly and dyspeptic subjects. Helicobacter pylori was not associated with dyspepsia, and was more prevalent in elderly subjects. There was a low prevalence of peptic ulcer in asymptomatic H. pylori-infected persons in this community.     

A study of the changes in the cause of peptic ulcer bleeding

AIM: To clarify the frequency of and changes in the cause of peptic ulcer bleeding. METHODS: This study retrospectively evaluated the out- and inpatients who underwent endoscopy between 2002 to 2008. The subjects were patients presenting with peptic ulcer bleeding. The details of these patients were obtained from their endoscopic reports and medical records. RESULTS: The rates of Helicobacter pylori (H. pylori ) infection were significantly low (P = 0.039), while the proportion of nonsteroidal antiinflammatory drugs (NSAIDs) users and vascular disease significantly increased over the period studied (P = 0.034 and P = 0.04, respectively). However, there was no significant difference in the proportion of low-dose aspirin users (P = 0.832).CONCLUSION: It’s found that the primary cause of peptic ulcer bleeding changed from H. pylori infection to use of NSAIDs over the 7-year period of study. It seems that the number of low-dose aspirin users has increased with the increase in the proportion of vascular disease. It is necessary to take measures to prevent peptic ulcer bleeding among NSAIDs and low dose aspirin users.     

Effects of killing Helicobacter pyloriquadruple therapy on peptic ulcer： A randomized double-blind clinical trial

AIM: To study the therapeutic efficacy of a Chinese and Western integrated regimen, killing Helicobacter pylori quadruple therapy on H pylori-associated peptic ulcers (PU). METHODS: With prospective and double-blind controlled method, seventy-five active PU patients with H pylori infection were randomized to receive one of the following three regimens: (1) new triple therapy (group A: lansoprazole 30 mg qd, plus clarithromycin 250 mg bid, plus amoxycillin 500 mg tid, each for 10 d); (2) killing Hp quadruple therapy(group B: the three above drugs plus killing H pylori capsule 6 capsules bid for 4 wk) and (3) placebo(group C: gastropine 3 tablets bid for 4 wk). H pylori eradication and ulcer healing quality were evaluated under an endoscope 4 wk after treatment. The patients were followed up for 5 years. RESULTS: Both the healing rate of PU and H pylori eradication rate in group B were significantly higher than those in group C (100% and 96.4% vs20% and 0%, respectively,P<0.005), but there was no significant difference compared to those in group A (88% and 92%, P>0.05). The healing quality of ulcer in group B was superior to that in groups C and A (P<0.05). The recurrence rate of PU in group B (4%) was lower than that in group A (10%) and group C (100%,P<0.01). CONCLUSION: Killing Helicobacter pylori quadruple therapy can not only promote the eradication of H pylori and healing quality of ulcer but also reduce recurrence rate of ulcer.     

Lewis blood genotypes of peptic ulcer and gastric cancer patients in Taiwan

AIM: The Lewis b (Leb) antigen has been implicated as a possible binding site for attachment of Helicobacter pylori (H pylori) to gastric mucosa. However, studies both supporting and denying this association have been reported in the literature. Differences in secretor (Se) genotype have been suggested as a possible reason for previous discrepancies. Therefore, we investigated the relationship between Le and Se genotypes and H pylori infection rates in people with peptic ulcer or gastric cancer. METHODS: Peripheral blood samples were obtained from 347 patients with endoscopic evidence of peptic ulcer disease (235 cases of duodenal ulcer, 62 of gastric ulcer, and 50 of combined duodenal ulcer/ gastric ulcer) and 51 patients with gastric cancer on endoscopy. Peripheral blood specimens from 101 unrelated normal volunteers were used as controls. Lewis phenotype was determined using an antibody method, whereas Le and Se genotypes were determined by DNA amplification and restriction enzyme analysis. Gastric or duodenal biopsies taken from patients with endoscopic evidence of peptic ulcer or gastric cancer were cultured for H pylori. Isolates were identified as H pylori by morphology and production of urease and catalase. The H pylori infection status was also evaluated by rapid urease test (CLO test), and urea breath test (13C-UBT). Results of studies were analyzed by chi-square test (taken as significant). RESULTS: H pylori was isolated from 83.7% (303/347) of patients with peptic ulcer disease. Statistical analysis did not show any significant difference in Lewis phenotype or genotype between patients with and without H pylori infection. No significant association was found between Lewis genotype and peptic ulcer or gastric cancer. CONCLUSION: Lewis blood genotype or phenotype may not play a role in the pathogenesis of H pylori infection. However, bacterial strain differences and the presence of more than one attachment mechanism may limit the value of epidemiological studies in elucidating this matter.