Recurrent peptic ulcers in patients following successful Helicobacter pylori eradication:: A multicenter study of 4940 patients

被引:67
作者
Miwa, H
Sakaki, N
Sugano, K
Sekine, H
Higuchi, K
Uemura, N
Kato, M
Murakami, K
Kato, C
Shiotani, A
Ohkusa, T
Takagi, A
Aoyama, N
Haruma, K
Okazaki, K
Kusugami, K
Suzuki, M
Joh, T
Azuma, T
Yanaka, A
Suzuki, H
Hashimoto, H
Kawai, T
Sugiyama, T
机构
[1] Juntendo Univ, Sch Med, Dept Gastroenterol, Bukyo Ku, Tokyo 1138421, Japan
[2] Tokyo Metropolitan Komagome Hosp, Dept Internal Med, Tokyo, Japan
[3] Jichi Med Sch, Dept Internal Med, Div Gastroenterol, Minami Kawachi, Tochigi, Japan
[4] Tohoku Univ, Grad Sch Med, Dept Gastroenterol, Sendai, Miyagi 980, Japan
[5] Osaka City Univ, Grad Sch Med, Dept Gastroenterol, Osaka, Japan
[6] Kure Kyosai Hosp, Dept Gastroenterol, Hiroshima, Japan
[7] Hokkaido Univ, Sch Med, Dept Endoscopy, Sapporo, Hokkaido 060, Japan
[8] Oita Med Univ, Dept Internal Med 2, Oita, Japan
[9] Iwate Med Univ, Dept Internal Med, Morioka, Iwate, Japan
[10] Wakayama Univ, Hlth Adm Ctr, Wakayama, Japan
[11] Tokyo Med & Dent Univ, Sch Med, Dept Internal Med 1, Tokyo 113, Japan
[12] Tokai Univ, Sch Med, Div Gen Internal Med, Kanagawa 2591100, Japan
[13] Kobe Univ, Sch Med, Dept Endoscopy, Kobe, Hyogo 650, Japan
[14] Kawasaki Med Sch, Dept Internal Med, Div Gastroenterol, Okayama, Japan
[15] Kyoto Univ Hosp, Dept Gastroenterol & Endoscop Med, Kyoto 606, Japan
[16] Nagoya Univ, Sch Med, Dept Internal Med 1, Aichi, Japan
[17] Natl Tokyo Med Ctr, Div Gastroenterol, Tokyo, Japan
[18] Nagoya City Univ, Grad Sch Med Sci, Dept Comprehens Med, Div Internal Med & Bioregulat, Aichi, Japan
[19] Fukui Med Sch, Dept Gastroenterol 2, Fukui, Japan
[20] Univ Tsukuba, Inst Clin Med, Dept Gastroenterol, Tsukuba, Ibaraki 305, Japan
[21] Keio Univ, Sch Med, Dept Internal Med, Tokyo, Japan
[22] Tokyo Womens Med Univ, Inst Geriatr, Tokyo, Japan
[23] Tokyo Med Univ, Dept Internal Med 4, Tokyo, Japan
[24] Hokkaido Univ, Grad Sch Med, Dept Gastroenterol, Sapporo, Hokkaido 060, Japan
关键词
D O I
10.1111/j.1083-4389.2004.00194.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Objective. Although curative treatment of Helicobaaer pylon infection markedly reduces the relapse of peptic ulcers, the details of the ulcers that do recur is not well characterized. The aim of this study is to describe the recurrence rate and specific features of peptic ulcers after cure of H. pylori infection. Methods. This was a multicenter study involving 4940 peptic ulcer patients who were H. pylori negative after successful eradication treatment and were followed for up to 48 months. The annual incidence of ulcer relapse in H. pylori-cured patients, background of patients with relapsed ulcers, time to relapse, ulcer size, and site of relapsed ulcers were investigated. Results. Crude peptic ulcer recurrence rate was 3.02% (149/4940). The annual recurrence rates of gastric, duodenal and gastroduodenal ulcer were 2.3%, 1.6%, and 1.6%, respectively. Exclusion of patients who took NSAIDs led annual recurrence rates to 1.9%, 1.5% and 1.3%, respectively. The recurrence rate was significantly higher in gastric ulcer. Recurrence rates of patients who smoked, consumed alcohol, and used NSAIDs were significantly higher in those with gastric ulcer recurrence compared to duodenal ulcer recurrence (e.g. 125 of 149 [83.9%] relapsed ulcers recurred at the same or adjacent sites as the previous ulcers). Conclusions. Curative treatment of H. pylori infection is useful in preventing ulcer recurrence. Gastric ulcer is more likely to relapse than duodenal ulcer. Recurrent ulcer tended to recur at the site of the original ulcers.
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页码:9 / 16
页数:8
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