医院门诊患者幽门螺杆菌感染及治疗现状

目的：探讨幽门螺杆菌（Hp）的感染率、抗Hp治疗的效果及影响疗效的相关因素。方法：454例用14C尿素呼气试验（14C-UBT）检测Hp的患者,记录其年龄、性别、Hp治疗方案1、4C-UBT结果等,分析其感染率及治疗效果。对调查数据行统计学分析。结果：在未抗Hp的患者中14C-UBT阳性率为53.7%,经抗Hp的患者中14C-UBT的阳性率为25.9%（P〈0.001）。在70例患者的具体治疗方案中常用的抗生素包括克拉霉素、左氧氟沙星和阿莫西林。14例（20%）患者经过2次或2次以上抗Hp治疗,治疗方案以含质子泵抑制剂（PPI）的三联治疗为主。4周后随访,77.1%患者14C-UBT转阴,其中19例患者在8周以后复查,其阳性率较低（15.8%）。7例四联治疗患者Hp全部根除。Logistic回归分析显示,14C-UBT的结果与抗Hp的次数和处方医师是否是消化科医师显著相关（P〈0.05）。29.6%的患者有不良反应。结论：常用的抗Hp治疗方案的有效率在77.1%左右,含铋剂的四联治疗方案有较高的根除率;患者的再感染率较低。

Helicobacter Pylori Infection in Outpatients in a Tertiary Hospital in China

Objective：To investigate the Helicobacter pylori（H.pylori） infection status in a tertiary hospital in China.Methods： 454 patients who underwent 14C-urease breath test（14C-UBT） for detection of H.pylori during October 2009 and December 2009 in Zhongshan Hospital Fudan University were included prospectively.Data on gender,age,anti-H.pylori regimen,result of breath test were collected.H.pylori infection status and anti-H.pylori effectiveness were analyzed.SPSS software 17.0 was used.Difference with p value0.05 was regarded as statistically significance.Results： 14C-UBT positivity was 53.7% among the patients without anti-H.pylori therapy and 25.9% among those who underwent anti-H.pylori therapy（P0.001）.Triple therapy was the common regimen.Fourteen patients（20%） underwent at least twice anti-H.pylori therapy.14C-UBT was negative in 54 patients（77.1%） at least 4 weeks after therapy and the positivity was even lower in patients who underwent the 14C-UBT after 8 weeks.14C-UBT was negative in all patients after quadruple therapy.Logistic regression showed that the frequency of anti-H.pylori therapy and whether gastroenterology administrated or not were the only two factors that affect the result of 14C-UBT.Conclusions： Eradication rate may be around 77.1% for common anti-H.pylori regimen.Quadruple therapy may raise the eradication rate.Re-infection of H.pylori may be low.