查看更多>>摘要：AIM:To evaluate the trends in the eradication rate of Helicobacter pylori (H.pylori) over the past 11 years in a single center.METHODS:This retrospective study covered the period from January 2000 to December 2010.We evaluated 5746 patients diagnosed with gastric ulcers (GU),duodenal ulcers (DU),GU + DU,or nonpeptic ulcers associated with an H.pylori infection.We treated them annually with the 2 wk standard first-line triple regimen,proton pump inhibitor (PPI) + amoxicilin + clarithromycin (PAC; PPI,clarithromycin 500 mg,and amoxicillin 1 g,all twice a day).The follow-up test was performed at least 4 wk after the completion of the 2 wk standard H.pylori eradication using the PAC regimen.We also assessed the eradication rates of 1 wk second-line therapy with a quadruple standard regimen (PPI b.i.d.,tripotassium dicitrate bismuthate 300 mg q.I.d.,metronidazole 500 mg t.i.d.,and tetracycline 500 mg q.i.d.) after the failure of the first-line therapy.Statistical analysis was performed with 95％CI for the differences in the annual eradication rates.RESULTS:A total of 5746 patients [2333 males (58.8％),1636 females (41.2％); mean age of males vs females 51.31 ± 13.1 years vs 52.76 ± 13.6 years,P ＜ 0.05,total mean age 51.9 ± 13.3 years (mean ± SD)] were investigated.Among these patients,1674 patients were excluded:35 patients refused treatment; 18 patients ceased H.pylori eradication due to side effects;1211 patients had inappropriate indications for H.pylori eradication,having undergone stomach cancer operation or chemotherapy; and 410 patients did not undergo the follow-up.We also excluded 103 patients who wanted to stop eradication treatment after only 1 wk due to poor compliance or the side effects mentioned above.Finally,we evaluated the annual eradication success rates in a total of 3969 patients who received 2 wk first-line PAC therapy.The endoscopic and clinical findings in patients who received the 2 wk PAC were as follows:gastric ulcer in 855 (21.5％); duodenal ulcer in 878 (22.1％); gastric and duodenal ulcer in 124 (3.1％),erosive,atrophic gastritis and functional dyspepsia in 2055 (51.8％); and other findings (e.g.,MALToma,patients who wanted to receive the therapy even though they had no abnormal endoscopic finding) in 57 (0.5％).The overall eradication rate of the 2 wk standard firstline triple regimen was 86.5％.The annual eradication rates from 2000 to 2010 were 86.7％,85.4％,86.5％,83.3％,89.9％,90.5％,88.4％,84.5％,89.1％,85.8％,and 88.3％,sequentially (P =0.06).No definite evidence of a significant change in the eradication rate was seen during the past eleven years.The eradication rates of second-line therapy were 88.9％,82.4％,85％,83.9％,77.3％,85.7％,84.4％,87.3％,83.3％,88.9％,and 84％ (P =0.77).The overall eradication rate of 1 wk quadruple second-line therapy was 84.7％.There was no significant difference in the eradication rate according to the H.pylori associated diseases.CONCLUSION:This study showed that there was no trend change in the H.pylori eradication rate over the most recent 11 years in our institution.
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