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Clin Gastroenterology H: 幽门螺杆菌再感染的治疗延迟会增加上消化道出血的风险

2021-01-18 MedSci原创 MedSci原创

幽门螺杆菌(H.pylori)感染是消化性溃疡的独立危险因素。 有研究表明,43-56%的消化性溃疡出血患者(PUB)存在幽门螺杆菌感染。

      幽门螺杆菌(H.pylori)感染消化性溃疡的独立危险因素。 有研究表明,43-56%的消化性溃疡出血患者(PUB)存在幽门螺杆菌感染。瑞典最近的一项研究表明,延迟根除幽门螺杆菌治疗会增加溃疡的风险并以时间依赖的方式出现并发症。本项研究旨在探究最初根除幽门螺杆菌治疗失败后直至复治的不同时间对随后的上消化出血(UGIB)风险的影响。

 

 

     研究人员对2003年1月至2012年12月接受基于克拉霉素三联疗法的70518例幽门螺杆菌感染患者进行了回顾性队列研究。初始治疗失败后需要再次治疗的患者有8330人,占11.8%。并根据根除幽门螺杆菌的最初和最终时间 (3个月或更短,3-12个月以及超过12个月)对病人进行了分类。主要观察结局是需要再治疗的患者和不需要再治疗的患者之间发生UGIB的差异。

 

 

      与对照组相比,即使在最后一次根除治疗后,仍需再次治疗的患者仍有较高的UGIB风险(HR为1.50、95%CI为1.34-1.69)。从最初的根除治疗到最终的根除治疗,时间越长,UGIB的风险会逐渐增加:小于3个月的风险比为1.16;95%CI,0.88–1.54,3–12个月的风险比为1.35;95%CI,1.07-1.69,超过12个月的危险比为1.68;95%CI,1.46-1.94(P = .038 )。

 

 

 

      本项研究最后作者说道:与最初治疗有反应的患者相比,那些最初根除幽门螺杆菌失败的患者发生UGIB的风险增加。随着重新治疗的时间延长,风险逐渐增加。应考虑在3个月内尽早重新治疗,以最大程度降低随后的UGIB风险。

 

 

 

原始出处:

Chuan-Guo Guo. Et al. Delay in Retreatment of Helicobacter pylori Infection Increases Risk of Upper Gastrointestinal Bleeding. Clin Gastroenterology H.2021.

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    2021-06-12 kcb069
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    2021-04-25 许安
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