Clinical trial: prolonged beneficial effect of Helicobacter pylori eradication on dyspepsia consultations - the Bristol Helicobacter Project
Clinical trial: prolonged beneficial effect of Helicobacter pylori eradication on dyspepsia consultations - the Bristol Helicobacter Project
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DOI：
10.1111/j.1365-2036.2010.04363.x
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发表时间：
2010-08-01
影响因子：
7.6
通讯作者：
Murray, L.
中科院分区：
文献类型：
--
作者：
Harvey, R. F.;Lane, J. A.;Murray, L.
背景幽门螺杆菌（Helicobacter pylori，Hp）慢性胃感染在世界范围内广泛存在，是引起消化性溃疡和胃癌的主要原因。社区根除感染的项目产生了短期效益，但关于累积的长期效益的信息很少。pylori感染产生进一步的好处后，最初的2年期间，判断减少GP咨询为dyspeptide.MethodsA共1517人，年龄20-59岁，谁是注册与七个一般做法，弗伦谢卫生区，布里斯托，有一个积极的13 C-尿素呼气试验H。pylori感染，并进入一个随机双盲试验的H。幽门螺杆菌根除治疗。2年后，我们发现全科医生因消化不良而进行的咨询减少了35%（先前报道）。在这项研究的扩展中，我们分析了治疗后2 - 7年的消化不良咨询。结果治疗后2 - 7年，81/764（10.6%）随机接受积极治疗的参与者因消化不良咨询，（14.1%）接受安慰剂的患者，减少了25%，比值比0.84（0.71，1.00），P = 0.042。结论根除H.社区中的幽门螺杆菌感染提供了累积的长期益处，持续减少严重到需要咨询全科医生的消化不良的发展，长达至少7年。从社区H的这一方面节省的成本。幽门螺杆菌根除计划，除了其他理论上的好处，使这些计划值得认真考虑，特别是在人群中的高流行率的H。幽门感染
P>BackgroundChronic infection of the stomach with Helicobacter pylori is widespread throughout the world and is the major cause of peptic ulcer disease and gastric cancer. Short-term benefit results from community programmes to eradicate the infection, but there is little information on cumulative long-term benefit.AimTo determine whether a community programme of screening for and eradication of H. pylori infection produces further benefit after an initial 2-year period, as judged by a reduction in GP consultations for dyspepsia.MethodsA total of 1517 people aged 20-59 years, who were registered with seven general practices in Frenchay Health District, Bristol, had a positive 13C-urea breath test for H. pylori infection and were entered into a randomized double-blind trial of H. pylori eradication therapy. After 2 years, we found a 35% reduction in GP consultations for dyspepsia (previously reported). In this extension to the study, we analysed dyspepsia consultations between two and 7 years after treatment.ResultsBetween two and 7 years after treatment, 81/764 (10.6%) of participants randomized to receive active treatment consulted for dyspepsia, compared with 106/753 (14.1%) of those who received placebo, a 25% reduction, odds ratio 0.84 (0.71, 1.00), P = 0.042.ConclusionsEradication of H. pylori infection in the community gives cumulative long-term benefit, with a continued reduction in the development of dyspepsia severe enough to require a consultation with a general practitioner up to at least 7 years. The cost savings resulting from this aspect of a community H. pylori eradication programme, in addition to the other theoretical benefits, make such programmes worthy of serious consideration, particularly in populations with a high prevalence of H. pylori infection.