根除幽门螺杆菌对胃溃疡愈合质量及复发的影响研究

目的探讨幽门螺杆菌（Helicobacter pylori，Up）对胃溃疡愈合质量及复发的影响。方法120例坳阳性活动期胃溃疡患者，口服泮托拉唑、阿莫西林、甲硝唑一周后，继续口服泮托美拉唑5周。治疗结束后复查胃镜取病理组织学检查并检测Hp根除情况，对比却根除组与却根除失败组内镜下溃疡愈合形态差异和愈合质量（包括内镜下再生黏膜成熟度和再生黏膜组织学成熟度）。所有患者随诊1年以上了解溃疡复发情况。结果治疗后92例胃溃疡患者月p检测阴性，坳根除率为80．43％；却根除组与跏根除失败组在内镜下愈合率方面的差异无显著性意义（P〉0．05），但两组在再生黏膜成熟度和再生黏膜组织学成熟度方面的差异有显著性意义（P〈0．01）。坳根除组1年溃疡复发率为4．35％，却根除失败组为21．43％，两组差异有显著性意义（P〈0．05）。结论根除Hp可提高胃溃疡的愈合质量，减少溃疡病复发。     

中国上消化道疾病患者幽门螺杆菌感染根除前后胃粘膜病理改变与空泡毒素活性的关系

目的：观察幽门螺杆菌（H.pylori)阳性消化性溃疡病和慢性胃炎患者H.pylori根除前后胃粘膜病理改变与空泡毒素（VacA)活性的关系。方法：功能性消化不良伴H.pylori感染的中国患者74例,于H.pylori根除前和4－6周后作胃镜检查,根据新悉尼病理分级法按半定量记分对治疗前后的胃粘膜病理变化程度进行分级。结果：VacA^ 菌检出率为80％（59／74）,消化性溃疡病患者的检出率与慢性胃炎患者无明显差别;VacA^ 和VacA^-组患者的H.pylori根除率亦无明显差别。根除治疗前,VacA^ 和VacA^-组患者的胃粘膜慢性炎症、活动性、表面上皮损伤、萎缩、肠化和淋巴滤泡数量无显著差别;治疗后4－6周,两组患者的胃窦粘膜炎症活动性、表面上皮损伤和慢性炎症程度均明显减轻,尤以前者为著（P＜0．0001）,VacA^ 组患者的胃窦部淋巴滤泡数量减少亦稍较VacA^-组明显（P＝0．051）,两组患者的胃粘膜萎缩和肠化程度均无明显好转。结论：中国上消化道疾病患者H.pylori感染根除前后的胃粘膜病理改变与VacA活性无明显关系。成功根除H.pylori感染并不引起萎缩和肠化的逆转。     

胃癌中幽门螺杆菌感染与原癌基因c—met表达及预后研究

目的　研究幽门螺杆菌(Hp)感染的胃癌(GC)组织中c-met表达及(Hp)感染对胃癌预后的影响。方法　经病理证实,不同病变胃粘膜145例以免疫组化检测c-met基因表达,以W-S法及快速尿素酶试验检测(Hp)感染。结果　在浅表性胃炎(CSG)、萎缩肠化生胃炎(CAG+IM)、异型增生(DYS)、早期GC和进展期GC中,c-met基因表达率分别为25.53%,51.28%,61.54%,66.67%和68.42%,CAG+IM、DYS、GC均显著高于CSG(P＜0.05)。肠型胃癌c-met阳性表达与(Hp)感染密切相关。CAG+IM,DYS和GC组c-met阳性表达(Hp)感染者明显高于阴性组。(Hp)阳性者5年生存期显著短于(Hp)阴性者。结论　(Hp)感染和c-met表达与胃粘膜增殖和恶化有关,前者也与胃癌预后有关。     

幽门螺杆菌阳性胃溃疡除菌治疗的临床研究

目的研究根除幽门螺杆菌（Hp）治疗对Hp阳性的胃溃疡愈合率、愈合质量及复发的影响。方法将68例Hp阳性的胃溃疡患者随机分为除菌组和非除菌组，除菌组给予奥美拉唑20mg＋阿莫西林0．5g＋呋喃唑酮0．1g口服，2次／d，1周后奥美拉唑改为20mg，1次／d，共治疗4周。非除菌组单独给予奥美拉唑，剂量方法同上。分别于4周及1年后复查胃镜。结果除菌组和非除菌组比较，4周后溃疡愈合率差异无统计学意义（分别为97．4％和90％，P〉0．05），但两组溃疡愈合质量比较差异有统计学意义。1年后两组溃疡复发率比较，除菌组低于非除菌组，差异有统计学意义（分别为6．7％和59．3％，P〈0．01），Hp根除率除菌组高于非除菌组，差异有统计学意义（分别为86．7％和3．7％，P〈0．01）。结论Hp感染与胃溃疡存在相关性，根除Hp治疗不仅可以提高溃疡的愈合质量，而且还可以减少溃疡的复发。     

Helicobacter pylori associated gastric intestinal metaplasia: Treatment and surveillance

Gastric cancer(GC) is one of the leading causes of cancer related death in the world, particularly in East Asia. According to the Correa's cancer cascade, noncardia GC is usually developed through a series of mucosal changes from non-atrophic gastritis to atrophic gastritis(AG), intestinal metaplasia(IM), dysplasia and adenocarcinoma. Atrophic gastritis and IM are therefore generally considered to be pre-neoplastic gastric lesions. Helicobacter pylori(H. pylori) infection is an important initiating and promoting step of this gastric carcinogenesis cascade. Emerging long-term data showed that eradication of H. pylori reduced the risk of subsequent cancer development. It however remains confusing whether eradication of the bacterium in individuals with pre-neoplastic gastric lesions could regress these changes as well as in preventing cancer. Whilst H. pylori eradication could likely regress AG, the presence of IM may be a point of no return in this cascade. Hence, surveillance by endoscopy may be indicated in those with extensive IM or those with incomplete IM, particularly in populations with high GC risk. The optimal interval and the best tool of surveillance endoscopy remains to be determined in future studies.     

根除幽门螺杆菌对胃窦黏膜萎缩和肠上皮化生逆转影响的前瞻性研究

目的 探讨根除幽门螺杆菌(Hp)对逆转胃窦黏膜萎缩和肠上皮化生(肠化生)病理改变的作用.方法 对行胃镜检查的门诊患者,于胃窦处取黏膜活检行病理学检查,并确定Hp感染状态.将Hp感染的慢性胃炎伴胃窦黏膜萎缩或(和)肠化生患者作为入选对象并分为两组,一组行Hp根除治疗,为Hp根除组(48例);另一组未行抗Hp治疗,为对照组(38例).分别在1年和5年后对两组患者进行胃镜随访,并在同一部位取材,根据2次病理结果的不同分为逆转和未逆转两种情况.结果 胃窦黏膜萎缩逆转率在Hp根除组显著高于对照组(37.1%比12.0%).5年后Hp根除组的胃窦黏膜萎缩逆转率显著高于1年后,45岁以下者显著高于45岁以上者.而在对照组中,胃窦黏膜萎缩逆转和随访的时间及年龄无明显关系.在2次随访中,肠化生逆转率在Hp根除组和对照组间差异均无统计学意义(P>0.05).结论 根除Hp尚不能逆转胃窦黏膜肠化生,但对逆转胃窦黏膜萎缩有作用,这种作用与随访观察时间及患者的年龄有关.因此,对有Hp感染的胃窦黏膜萎缩者应及早行根除Hp治疗.     

Hp相关性胃疾病与胃肠化生、不典型增生的关系

目的探讨Hp感染与肠化生、不典型增生等胃癌前期病变的关系.方法693例胃病患者,分慢性浅表性胃炎(CSG)、慢性萎缩性胃炎(CAG)、胃溃疡(GU)及十二指球部溃疡(DU)等四组,胃镜下观察粘膜病变、溃疡部位及性质,胃镜下取材,常规HE染色后观察组织学改变、Giemsa染色后观察Hp感染程度,统计分析Hp感染与肠化生、不典型增生等的关系.结果四组胃疾病中,Hp感染程度与肠化尘程度差异显著(P＜0.01),DU组的Hp感染率高于其它组(P＜0.01),CAG组的胃肠化生率最高(P＜0.05);Hp阳性标本中,CAG组的胃肠化及不典型增生最高(P＜0.01)Hp阴性标本中,CAG组的胃肠本的胃肠化和不典型增生发生率与Hp阴性标本的发生率有显著差异(P＜0.05).结论Hp与CAG并存时,癌前病变发生率最高,其次为GU;建议在临床上,抗Hp治疗和对CAG、GU的治疗同时进行,并内镜随访.     

复合性溃疡48例分析

我院90～95年期间经内镜诊断的48例复合性溃疡(CU),占同期1528例消化性溃疡病人的3.14%.其中幽门口变形或狭窄14例(29.1%),其CU的发生与幽门功能异常有关.经活检证实幽门螺杆菌(Hp)感染阳性14例中,11例幽门口圆,开闭好,结合病理检查考虑 Hp感染导致粘膜炎症并形成溃疡.本组内科治疗有效率为89.7%,鉴于Hp感染和溃疡形成有关,并影响溃疡的瘢痕形成,所以根除Hp对CU的治疗及防止复发有重要意义.     

MMP-9、TIMP-1在胃溃疡组织中的表达及与组织学的关系

目的研究基质金属蛋白酶-9(MMP-9)及其组织抑制物-1(TIMP-1)在胃溃疡组织的表达及其与组织学的相关性,探讨胃溃疡愈合的分子机制。方法 50例胃溃疡患者与20例正常对照者,经胃镜检查取胃溃疡部位及胃窦部位活检组织,并检测幽门螺杆菌感染,按悉尼标准进行组织学评价,进行组织培养并检测培养液上清MMP-9、TIMP-1浓度,分析MMP-9、TIMP-1与组织学的关系。结果 MMP-9、TIMP-1在胃溃疡部位[(51.6±20.3)mg/mL、(31.5±6.7)mg/mL]的表达高于对照组[(23.1±12.5)mg/mL、(16.2±5.3)mg/mL,P=0.001、P=0.000],且与组织学的活动性及炎症分级相关(P<0.05),而与萎缩、肠上皮化生分级等无相关性(P>0.05)。结论胃溃疡患者MMP-9、TIMP-1的表达增加,可能与胃溃疡的愈合有关。     

胃粘膜肠化与幽门螺杆菌分布的关系

目的：探讨胃癌高发地区人群中胃粘膜肠化与幽门螺杆菌（Ｈ．ｐｙｌｏｒｉ）分布的关系。方法：对５３３例胃癌高发地区成年人行内镜及胃粘膜活检组织学检查,Ｗａｒｔｈｉｎ－Ｓｔａｒｒｙ染色阳性定为Ｈ．ｐｙｌｏｒｉ感染。结果：５３３例成年人的Ｈ．ｐｙｌｏｒｉ检出率为６４．５％。Ｈ．ｐｙｌｏｒｉ阳性组肠化检出率为５５．５％,阴性组肠化检出率为３１．８％（Ｐ〈０．０１）。Ｈ．ｐｙｌｏｒｉ阳性组无肠化和轻、中、重度     

治疗的依从性、年龄、性别对胃溃疡患者使用三联7天疗法根除幽门螺杆菌治疗的影响

目的研究胃溃疡患者使用三联7天疗法治疗幽门螺杆菌（Helicobacter pylori,H.pylori）感染的根除率,评估患者依从性、年龄、性别对于此类人群根除H.pylori治疗的影响。方法将经胃镜检查确诊为新发胃溃疡,并经活组织病理学检查明确有H.py-lori感染的1 075例患者纳入研究范围,所有入选患者均接受三联（洛赛克或耐信20 mg/次、2次/天,联合克拉霉素500 mg/次、2次/天,与阿莫西林1 000 mg/次、2次/天）7天疗法行根除H.pylori治疗,之后予以耐信或洛赛克20 mg/次、1次/天、治疗49天。所有入选患者系统治疗完成后6-8周复查胃镜。结果40-59岁与60岁以上人群的胃溃疡患者对治疗的依从性差异无显著性,而40岁以下人群对治疗的依从性较差（P〈0.05）。〈40岁、40-59岁和≥60岁胃溃疡患者的H.pylori根除率分别为61.0%、72.7%和81.9%。〈40岁与40-59岁和≥60岁患者的H.pylori根除率差异有统计学意义（P〈0.05）。不同性别胃溃疡患者的H.pylori根除率差异无显著性（P〉0.05）。结论使用三联7天疗法治疗胃溃疡患者的H.pylori感染,H.pylori的根除率较低,患者对治疗的依从性、年龄是影响胃溃疡患者H.pylori根除率的重要因素,而性别对此无影响。     

幽门螺杆菌与消化性溃疡关系的10年随访研究

目的 探讨根除幽门螺杆菌(Helicobacter pylori,Hp)后10年间十二指肠球部溃疡(DU)、胃溃疡(GU)发病情况.方法 选择胃癌高发区山东烟台高陵镇随机抽样自然人群进行内镜普查,其中Hp阳性者552例均分为治疗组和安慰剂组,治疗组276例予以奥美拉唑20 mg、克拉霉素0.5 g和阿莫西林1.0 g,每日2次口服,疗程7 d.停药1个月后治疗组行13C-尿素呼气试验(13C-UBT)证实根除成功.此后对两组在10年期间进行内镜随访(第1、5、8和10年),观察两组患者消化性溃疡发病率的变化及复发情况,同时观察两组Hp感染状态的变迁.结果 治疗组消化性溃疡第1、5和8年的发病率分别为3.70%、5.86%和4.40%,均明显低于安慰剂组(12.85%、14.93%和9.39%,P值分别=0.0002、0.0017和0.0440).随访10年间,治疗组消化性溃疡新发病例数及复发病例数均低于安慰剂组,两组间差异均有统计学意义(P值均<0.05).治疗组Hp再感染率较高,第10年时Hp阳性率达46.4%.根据Hp感染状态重新进行分组,结果显示随访10年间Hp阴性组消化性溃疡的发病率均低于Hp阳性组(P值均<0.05).结论 根除Hp治疗后消化性溃疡的发病率和复发率均明显降低,消化性溃疡患者根除Hp是必要的.成功根除Hp后再感染率仍较高.     

幽门螺杆菌相关胃溃疡的细胞增殖与凋亡研究

目的观察Ｈｐ感染对胃溃疡（ＧＵ）患者胃粘膜上皮细胞增殖与凋亡的影响,进而对溃疡发生机制进行探讨．方法标本取自内镜下胃粘膜活检,细胞凋亡检测采用Ｔｕｎｅｌ方法,细胞增殖检测采用免疫组化ＬＳＡＢ方法测定增殖细胞核抗原（ＰＣＮＡ）．结果ＧＵＨｐ＋患者细胞凋亡指数（ＡＩ）明显高于Ｈｐ－患者（Ｐ＜００５）,但比较两者的增殖细胞指数（ＰＣＮＡＬＩ）,无显著性差异（Ｐ＞００５）;慢性浅表性胃炎Ｈｐ＋患者ＡＩ,ＰＣＮＡＬＩ明显高于Ｈｐ－患者（Ｐ＜００５）,ＧＵＨｐ＋患者的ＡＩ／ＰＣＮＡＬＩ比值为１５４１,明显高于其他各组（Ｐ＜００５）．结论Ｈｐ感染能诱导ＧＵ患者胃粘膜上皮细胞凋亡增加,出现细胞凋亡与细胞增殖平衡失调,促进溃疡形成     

Genetic alterations in benign lesions： Chronic gastritis and gastric ulcer

AIM:To investigate the occurrence of chromosome 3,7,8,9,and 17 aneuploidies,TP53 gene deletion and p53protein expression in chronic gastritis,atrophic gastritisand gastric ulcer,and their association with H pylori in-fection.METHODS:Gastric biopsies from normal mucosa(NM,n=10),chronic gastritis(CG,n=38),atrophic gastritis(CAG,n=13)and gastric ulcer(GU,n=21)were studiedusing fluorescence in situ hybridization(FISH)and im-munohistochemical assay.A modified Giemsa stainingtechnique and PCR were used to detect H pylori.An as-sociation of the gastric pathologies and aneuploidies withH pylori infection was assessed.RESULTS:Aneuploidies were increasingly found from CG(21%)to CAG(31%)and to GU(62%),involving mainlymonosomy and trisomy 7,trisomies 7 and 8,and triso-mies 7,8 and 17,respectively.A significant associationwas found between H pylori infection and aneuploidiesin CAG(P=0.0143)and GU(P=0.0498).No TP53 dele-tion was found in these gastric lesions,but p53-positiveimmunoreactivity was detected in 45%(5/11)and 12%(2/17)of CG and GU cases,respectively.However,therewas no significant association between p53 expressionand H pylori infection.CONCLUSION:The occurrence of aneuploidies in be- nign lesions evidences chromosomal instability in earlystages of gastric carcinogenesis associated with H pyloriinfection,which may confer proliferative advantage.Theincrease of p53 protein expression in CG and GU may bedue to overproduction of the wild-type protein related toan inflammatory response in mucosa.     

Clinical relevance of Helicobacter pylori CagA-positive strains: gastroduodenal peptic lesions marker.

OBJECTIVES: peptic ulcer is characterized by its recurrent nature, which necessitates maintenance treatment in most patients. But this natural history can be changed in patients with peptic ulcer associated to Helicobacter pylori, as shown by the low rates of recurrence and decreased hemorrhagic recidivism associated with this infection. Whether CagA or VacA strains are associated with a greater risk of peptic ulcer is controversial. This study was designed to examine endoscopic findings and their relation with H. pylori phenotype (CagA or VacA). METHODS: 106 selected dyspeptic patients underwent upper gastrointestinal tract endoscopic examination between September 1996 and May 1997 [69 with H. pylori (Hp) and 37 without this infection]. Endoscopic findings were classified as gastric ulcer (GU), duodenal ulcer (DU), gastric erosions (GE), duodenitis (Du), chronic gastritis (CG) and normal mucosa (NM). Hp phenotype was analyzed with a western blot test. RESULTS: 75% of H. pylori strains were CagA-positive and 54.2% were VacA-positive. 82.4% of the cases of DU were associated with a CagA+ phenotype, but the association was not statistically significant. Otherwise 100% of gastric ulcers were associated with CagA+ strains (p < 0.005). VacA phenotype was not associated with any particular endoscopic finding. Peptic ulcer (DU or GU) was also associated with the CagA+ phenotype (p < 0.05). CONCLUSIONS: the CagA+ H. pylori phenotype seems to be a peptic lesion marker, but was more frequently related with GU than with DU in our sample of Spanish patients.     

Optimal initiation of Helicobacter pylori eradication in patients with peptic ulcer bleeding

AIM:To evaluate when Helicobacter pylori(H.pylori)eradication therapy(ET)should be started in patients with peptic ulcer bleeding(PUB).METHODS:Clinical data concerning adults hospitalizedwith PUB were retrospectively collected and analyzed.Age,sex,type and stage of peptic ulcer,whether endoscopic therapy was performed or not,methods of H.pylori detection,duration of hospitalization,and specialty of the attending physician were investigated.Factors influencing the confirmation of H.pylori infection prior to discharge were determined using multiple logistic regression analysis.The H.pylori eradication rates of patients who received ET during hospitalization and those who commenced ET as outpatients were compared.RESULTS:A total of 232 patients with PUB were evaluated for H.pylori infection by histology and/or rapid urease testing.Of these patients,53.7%(127/232)had confirmed results of H.pylori infection prior to discharge.In multivariate analysis,duration of hospitalization and ulcer stage were factors independently influencing whether H.pylori infection was confirmed before or after discharge.Among the patients discharged before confirmation of H.pylori infection,13.3%(14/105)were lost to follow-up.Among the patients found to be H.pylori-positive after discharge,41.4%(12/29)did not receive ET.There was no significant difference in the H.pylori eradication rate between patients who received ET during hospitalization a n d t h o s e w h o c o m m e n c e d E T a s o u t p a t i e n t s[intention-to-treat:68.8%(53/77)vs 60%(12/20),P=0.594;per-protocol:82.8%(53/64)vs 80%(12/15),P=0.723].CONCLUSION:Because many patients with PUB who were discharged before H.pylori infection status was confirmed lost an opportunity to receive ET,we should confirm H.pylori infection and start ET prior to discharge.     

Recurrence of Helicobacter pylori infection and the long-term outcome of peptic ulcer after successful eradication in Japan.

Recurrence of peptic ulcer after successful eradication of Helicobacter pylori is closely associated with reinfection. The aim of this study was to examine the recurrence of peptic ulcer and reinfection with H. pylori after successful eradication. To eradicate H. pylori infection, patients with active peptic ulcer disease were assigned to two treatment groups depending on the year of their enrollment (AM group and OAMR group). Patients in the AM group received 400 mg of cimetidine twice per day, 300 mg of amoxicillin three times per day, and 250 mg of metronidazole three times per day for 2 weeks. Patients in the OAMR group received 20 mg of omeprazole once per day, 500 mg of amoxicillin granules three times per day, 250 mg of metronidazole three times per day, and 150 mg of roxithromycin twice per day for 1 week. After endoscopy verified ulcer scarring and successful eradication of H. pylori infection, study patients were followed up monthly and did not undergo acid-suppressive therapy. Endoscopy was performed at 6-month intervals for the 1st year. After the 1st year, follow-up endoscopies were performed annually. In total, 107 patients with peptic ulcer (duodenal ulcer [DU], 65; gastric ulcer [GU], 42) were followed up for a mean period of approximately 2 years. Recurrence of infection occurred in 10 (9.3%) of 107 patients (AM group, 9; OAMR group, 1) after 210 patient-years of follow-up; the recurrence rate was 4.8% per patient-year. Recurrence of H. pylori infection was significantly higher in the AM group (23.1%) than in the OAMR group (1.5%). H. pylori infection recurred in two patients 6 months after eradication therapy, in seven 1 year after, and in one 2 years after. Thereafter, no further cases of H. pylori recurrence were observed. During follow-up periods, seven cases of ulcer recurrence were observed (DU, 4; GU, 3). The rate of peptic ulcer recurrence within 2 years after eradication therapy was significantly higher than that after more than 2 years. Four cases of ulcer recurrence (DU, 3; GU, 1) also had recurrence of H. pylori infection. One recurrent case of DU without reinfection was associated with nonsteroidal anti-inflammatory drugs. The remaining two cases of GU recurred without H. pylori reinfection. In conclusion, peptic ulcer recurrence rarely occurred (3 [2.9%] of 103) in patients cured of H. pylori infection. Reinfection after apparent successful eradication was rarely noted when a powerful therapeutic regimen in eradication was used. Therefore, to eradicate H. pylori, a highly effective therapeutic regimen should always be used.     

胃溃疡患者血清瘦素体重指数变化与幽门螺杆菌感染的关系研究

目的探讨胃溃疡患者的血清瘦素水平、体重指数(BMI)及其与幽门螺杆菌(Hp)感染的关系。方法将武汉大学人民医院2007年9月至2008年3月收治的31例Hp阳性的胃溃疡患者分为2组:抗Hp根治成功组22例,抗Hp根治失败组9例;12例Hp阴性胃溃疡患者给予抗溃疡治疗;14名正常人为对照组。治疗开始前及3个月后测定BMI、血清瘦素、症状评分、胃组织内白介素-8(IL-8)mRNA和蛋白质水平。结果治疗前Hp阳性胃溃疡组的IL-8mRNA和蛋白质 显著高于Hp阴性胃溃疡组、对照组(P<0.05)。治疗后,Hp阳性胃溃疡组IL-8mRNA和蛋白质表达、所有胃溃疡患者的血清瘦素和症状评分均降低(P<0.05),抗Hp根治成功患者、Hp阴性患者的BMI升高(P<0.05)。IL-8与瘦素或BMI改变无关,症状评分与血清瘦素和BMI变化均呈正相关(P<0.05)。结论胃溃疡患者症状的改善可能与其瘦素和BMI改变相关。     

幽门螺杆菌球形菌与溃疡复发关系的临床研究

目的：探讨幽门螺杆菌（Ｈｐ）球形菌与溃疡复发的关系。方法：１１例Ｈｐ阳性活动期十二指肠溃疡（ＤＵ）患者，经标准三联疗法（铋剂１０ｍｇ、四环素５００ｍｇ、甲硝唑４０ｍｇ，每日３次共１４天）治疗后４周，复查胃镜，胃粘膜涂片Ｇｒａｍ及免疫组织化学染色检查Ｈｐ球形菌，以及尿素酶试验和ＰＣＲ检测。结果：ＤＵ愈合率９６％，Ｈｐ根除率８５％。１２人检出Ｈｐ球形菌且ＤＵ均愈合占１０４％，其中９人完成一年随访，溃疡均复发占１０％，涂片均检出典型Ｈｐ。而Ｈｐ根除组８６人随访一年４人溃疡复发占４７％，均为Ｈｐ阳性。比较两组溃疡复发率差异显著（Ｐ＜００５）。结论：Ｈｐ球形菌可致溃疡复发     

幽门螺杆菌感染根除与老年消化性溃疡发生、复发关系的研究

目的　探讨老年消化性溃疡发生、复发与幽门螺杆菌 (Hp)感染的关系。方法　应用 PCR法对 78例老年性消化性溃疡幽门螺杆菌感染及幽门螺杆菌感染根除治疗后半年、 1年幽门螺杆菌再感染者进行了测定。结果　幽门螺杆菌检出率老年组明显高于青年组 ,Hp根治率青年组明显高于老年组 ,经 Hp根除治疗组溃疡愈合率明显高于未根除治疗组。结论　老年消化性溃疡发生与幽门螺杆菌感染密切相关 ,在溃疡治疗中 ,根除 Hp感染对减少溃疡复发具有重要临床意义