共同治疗策略对根除幽门螺杆菌的影响

[目的]研究存在幽门螺杆菌(Hp)感染家庭聚集的感染患者Hp根除治疗后复发情况,探讨共同根除治疗策略对远期根除Hp的影响。[方法]通过对内镜检查确诊的195例Hp感染患者的家庭成员采用13碳呼气试验进行Hp感染调查,筛选有家庭成员Hp感染的患者140例。按照对Hp感染家庭成员有无根除治疗,将140例随机分成家庭成员共同根治组和单独根治组,每组70例。治疗后每月随访患者感染复发情况,观察不同根治策略对Hp根除的影响。[结果]134例患者参与根治后4、6、12、18、24个月随访,其中家庭成员共同根除治疗患者68例,Hp感染复发患者分别为0、1、2、4、5例,累积复发率为7.4%,平均复发时间为(12.6±6.1)个月;而66例单独根治患者复发者则分别为3、5、9、11、13例,累积复发率为19.7%,平均复发时间为(11.1±6.3)个月。χ2检验分析发现,在根除治疗后4、6个月时,2组复发率比较差异无统计学意义(P0.05);随着时间推移,治疗后12、18、24个月,共同根治组患者Hp感染再发率显著少于单独根治组(P0.05)。[结论]从远期观察,对于存在Hp感染家庭聚集的Hp感染患者,Hp感染成员共同根除治疗可有效降低根治后感染再发。

Role of extensive eradication in Helicobacter pylori eradication

[Objective]To investigate recurrence rate after Helicobacter pylori （Hp） eradication of patients with Hp positive family members,and to explore the role of extensive eradication in long-term Hp recurrence.[Methods]A total of 195 Hp infected patients diagnosed through electronic endoscopy were enrolled,their family members were screened with urea breath test （UBT） for Hp infection investigation.One-hundred forty Hp infected patients whose familiar lived intimately were chosen to be followed up.The familiar and patients were randomly divided into separately treated group （separate-treated group） and group treated with all Hppositive members （all-treated group）.All patients were followed up after Hp eradication.[Results]A total of 134 patients were involved in this study,including 68 patients that were treated with all Hp positive members.There were 0,1,2,4,5 subjects were found Hp positive in 4,6,12,18,24 months after Hp eradication.The mean infection time was （12.6±6.1） months.Sixty-six patients treated separately were investigated.There were 3,5,9,11,13 subjects were found Hp positive in 4,6,12,18,24 months after Hp eradication.The mean infection time was（11.1±6.3） months.There was no significant difference in the recurrence rate between two groups at 4 and 6 months after the eradication treatment （P＞0.05）,but the recurrence rate was significantly different during the long-term investigation（P＜0.05）.The cumulative recurrence rate between the two groups was significantly different （P＜ 0.05）.[Conclusion]In families with members in close contact,extensive treatment for all Hp positive familiar is effective in preventing the long term recurrence of Hp infection.