Cure of peptic gastric ulcer associated with eradication of Helicobacter pylori. Finnish Gastric Ulcer Study Group.
Cure of peptic gastric ulcer associated with eradication of Helicobacter pylori. Finnish Gastric Ulcer Study Group.
复制标题
根除幽门螺杆菌可治愈消化性胃溃疡。
作者：
K. Seppälä;P. Pikkarainen;P. Sipponen;E. Kivilaakso;M. Gormsen
对239例胃溃疡患者进行多中心研究，探讨幽门螺杆菌根除对溃疡愈合及复发率的影响。幽门螺杆菌阳性胃溃疡患者被随机分为三组：(A) 84例患者接受甲硝唑治疗10天，亚柠檬酸铋（CBS）治疗8周；(B)甲硝唑安慰剂治疗10天，CBS治疗8周（73例）；(C)雷尼替丁（82例）。在210例患者的12周时，35例幽门螺杆菌阴性患者中有3例（9%）出现胃溃疡，175例幽门螺杆菌阳性患者中有45例（26%）出现胃溃疡（p < 0.05）。结果205例患者随访1年。在12 - 52周期间，29例幽门螺杆菌阴性患者发生2次（7%）溃疡复发，128例幽门螺杆菌阳性患者中60例（47%）溃疡复发（p < 0.001）。对溃疡复发患者进行两周的开放三联治疗（CBS 120 mg，每天4次，阿莫西林500 mg，每天4次，甲硝唑400 mg，每天3次）后，55例成功治疗的患者中只有1例（非甾体抗炎药使用者）在一年的随访中溃疡复发。成功根除幽门螺杆菌后，胃溃疡愈合迅速，复发少见。幽门螺杆菌的根除改变了胃溃疡的自然史。
The effect of Helicobacter pylori eradication on ulcer healing and the relapse rate were investigated in a multicentre trial of 239 gastric ulcer patients. Patients with H pylori positive gastric ulcer were randomly assigned to one of three groups: (A) 10 days' treatment with metronidazole and eight weeks' treatment with colloidal bismuth subcitrate (CBS) (84 patients); (B) 10 days' treatment with metronidazole placebo and eight weeks with CBS (73 patients); or (C) ranitidine (82 patients). At 12 weeks in 210 patients, gastric ulcer was present in three (9%) of 35 H pylori negative patients, and in 45 (26%) of 175 H pylori positive patients (p < 0.05). Results after one year of follow up were available for 205 patients. Between 12 and 52 weeks, two (7%) ulcer relapses occurred in 29 H pylori negative patients and in 60 (47%) of 128 H pylori positive patients (p < 0.001). After two weeks of open triple therapy (CBS 120 mg four times daily, amoxicillin 500 mg four times daily, and metronidazole 400 mg three times daily), given to the patients with ulcer relapse, only one (an NSAID user) of 55 successfully treated patients had an ulcer relapse during the one year follow up. Healing of gastric ulcer is rapid and recurrence is infrequent after successful H pylori eradication. H pylori eradication changes the natural history of the gastric ulcer disease.