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目的 探讨根除幽门螺杆菌 (Hp)对慢性糜烂性胃炎 (CEG)自然病程的影响。 方法 选择胃镜证实的CEG病人92例 ,均有Hp感染 (胃粘膜Giemsa染色和14 C 尿素呼吸试验二项均阳性 )。予奥美拉唑 2 0mg ,bid ;羟氨苄青霉素75 0mg ,bid ;甲硝唑 40 0mg ,tid ,疗程 2周。疗程结束后 4周复查胃镜和Hp ,糜烂愈合者分为A组 (Hp根除组 )和B组 (Hp未根除组 )进入随访阶段 ,随访观察 2年。结果 糜烂愈合 83例 ( 90 .2 % ) ,Hp根除 75例 ( 81.5 % ) ;Hp根除的糜烂愈合率 90 .7% ( 68/ 75 )与Hp未根除的愈合率 88.2 % ( 15 / 17)差异无显著性 (P >0 .0 5 ) ;A组第 1、2年糜烂复发率分别为 10 .4%和 3 0 .8% ,均显著低于B组的 66.7%和 86.7% (P <0 .0 0 5 )。结论 根除Hp并不能提高CEG的愈合率 ,但可显著减少其复发率。根除Hp有可能改变CEG的自然病程。
Objective To investigate the eradication of Helicobacter pylori (Hp) on the natural history of chronic erosive gastritis (CEG). Methods Ninety-two CEG patients confirmed by gastroscopy were infected with Hp (both Giemsa staining and 14 C urea respiration test were positive). To omeprazole 20mg, bid; amoxicillin 75 0mg, bid; Metronidazole 40 0mg, tid, course of treatment for 2 weeks. Gastroscope and Hp were examined 4 weeks after the end of treatment. Patients with erosion and healing were divided into group A (Hp eradication group) and group B (Hp non-eradication group). The patients were followed up for 2 years. Results Erosion healing rate was 88.2% (15/17) in 83 cases (90.2%) with eradication of Hp and 75 cases (81.5%) with eradication of Hp. The healing rate of eroded Hp was 90.7% (68/75) (P> 0.05). The recurrence rates of erosion in the first and second years in group A were 10.4% and 30.8%, respectively, which were significantly lower than those in group B (66.7% and 86.7%, P <0 0 0 5). Conclusion Eradication of Hp does not improve the healing rate of CEG, but it can significantly reduce the recurrence rate. Eradication of Hp may change the natural course of CEG.