目的:探讨拉萨地区上消化道溃疡患者幽门螺杆菌（Helicobacter pylori，H. pylori）感染情况及其与临床表现和预后的关系。方法:回顾性分析在拉萨市人民医院诊治的237例上消化道溃疡患者H. pylori感染情况，并比较H. pylori阳性与阴性患者在临床表现上的差异；其中169例H. pylori阳性患者进行根除治疗，中位随访13个月后评估Hp感染根除率和溃疡复发率。结果:拉萨地区上消化道溃疡患者中，H. pylori阳性率为72.6%。H. pylori阳性患者相对于阴性患者更易出现腹胀（40.7% vs 21.5%，χ2=2.907，P=0.006），但消化道出血症状较少见（45.3% vs. 67.7%，χ2=9.428，P=0.002），且并发症发生率较低（48.8% vs. 69.2%，χ2=7.910，P=0.005）。169例接受治疗的患者中，H. pylori根除率为82.7%。随访期间，两组溃疡复发率无统计学差异（P≈1.000，Fisher检验）。结论:拉萨地区上消化道溃疡患者中H. pylori感染较为常见，四联疗法显示根除H. pylori有一定疗效，但降低溃疡复发率仍需进一步研究。由于H. pylori阴性消化道溃疡患者并发症发生率更高，应该重视这部分患者的研究。
Helicobacter pylori infection in patients with upper gastrointestinal ulcer in Lhasa: clinical presentation, prognosis, and treatment outcomes
Objective:To investigate the prevalence of Helicobacter pylori (H. pylori) infection among upper gastrointestinal ulcer patients in Lhasa and its relationship with clinical presentation and prognosis.Methods:A retrospective analysis was conducted on 237 upper gastrointestinal ulcer patients treated at the People's Hospital of Lhasa City to determine the prevalence of H. pylori infection. The differences in clinical presentation between H. pylori-positive and H. pylori-negative patients were compared. In 169 H. pylori-positive patients, eradication therapy was performed, and the H. pylori eradication rate and ulcer recurrence rate were evaluated after a median follow-up of 13 months.Results:Among upper gastrointestinal ulcer patients in Lhasa, the prevalence of H. pylori infection was 72.6%. H. pylori-positive patients were more likely to experience abdominal distension compared to H. pylori-negative patients (40.7% vs 21.5%, χ2=2.907, P=0.006). However, gastrointestinal bleeding symptoms were less common (45.3% vs 67.7%, χ2=9.428, P=0.002) and the incidence of complications was lower (48.8% vs 69.2%, χ2=7.910, P=0.005) in H. pylori-positive patients. Among the 169 patients who received treatment, the H. pylori eradication rate was 82.7%. During the follow-up period, there was no statistically significant difference in ulcer recurrence rates between the two groups (P≈1.000, Fisher's exact test).Conclusion:H. pylori infection is common among upper gastrointestinal ulcer patients in Lhasa. Quadruple therapy demonstrates some efficacy in eradicating H. pylori, but further research is needed to reduce ulcer recurrence rates. Given the higher incidence of complications in H. pylori-negative upper gastrointestinal ulcer patients, it is important to focus on studying this subgroup of patients.
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