幽门螺杆菌感染对非甾体类抗炎药消化性溃疡转归的研究

目的:探讨幽门螺杆菌(Hp)感染对非甾体类抗炎药(NSAIDs)消化性溃疡(PU)转归的影响。方法:将200例确诊NSAIDs消化性溃疡和感染Hp患者分为根除Hp组100例和抑酸组100例。根除组给奥美拉唑20mg,2次/d,克拉霉素0.5g,2次/d,阿莫西林1.0g,2次/d,共2周。两周后给奥美拉唑20mg/d治疗6周;抑酸组给奥美拉唑20mg/d,共8周。两组患者在治疗后4周、48周进行胃镜和Hp复查,对比溃疡的愈合率、复发率、并发症发生率情况。结果:根除组Hp根除率为97%,两组溃疡愈合率差异无统计学意义(88.7%,87.0%,P>0.05);48周内溃疡复发率:抑酸组明显低于根除组(13.0%,27.8%,P<0.05);胃溃疡(GU)并出血发生率:抑酸组明显低于根除组(15.0%,28.9%,P<0.05);十二指肠溃疡(DU)并出血发生率:两组差异无统计学意义(10.0%,11.3%,P>0.05)。结论:Hp和NSAIDs是消化性溃疡发生的两个重要独立危险因素,Hp感染并不影响NSAIDs性溃疡的愈合,并可能降低其近期的复发。Hp感染与NSAIDs性溃疡引起的出血呈明显反比关系,与十二指肠溃疡出血无关。

Effect of H.pylori on outcome of non-steroid anti-inflammatory drug in pepticUlcer

Objective：To study the effect of H. pylori （Hp）infection on outcome of patients with peptic ulcer treated by nonsteroidal anti-inflammatory drugs （NSAIDs）. Methods：200 patients with peptic ulcer and Hp infection were divided into Hp group （100 cases） and antacid grop （100 cases） in case-control study. Patients in Hp group were treated with Omeprazole 20rag Bid, Clarithromycin 0.5 Bid, Amoxicilline 1.0 Bid for 2 weeks. Then Omeprazole 20mg qd for 6 weeks. Patients in antiacid grop were treated with Omeprazole 20mg qd for 8 weeks. All patients were given endoscopies and Hp examinations in 4 weeks and 48 weeks. The cure rate,recurrent rate and complication rate were compared between the two groups . Results ：The eradication rate of Hp group was 97% ,the cure rates of the two groups had no significant difference （88.7%, 87.0% ,P〉0. 05）. The ulcer recurrent rate in 48 weeks in antacid group was significantly lower than that in Hp group（13. 0%, 27.8%, P（0.05）. Incidence of bleeding gastric ulcers in antacid group was significantly lower than that in Hp eradication group （15. 0%, 28. 9%, P（0. 05）. Incidences of bleeding duodenal ulcers had no significant difference between two groups （10. 0 %.0,11.3 %, P〉0. 05）. Conclusion ： Hp and NSAIDs are two independent risk factors of peptic ulcer, they won/t work in coop-eration. NSAIDs peptic ulcer doesn/t affect by Hp infection, and the presence of Hp is associated with a lower risk of short-term recurrence. There is a negative interaction between Hp and NSAID used in patients with bleeding gastric ulcer, but no interaction is found between Hp and bleeding duodenal ulcer.