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目的 通过长期随访观察根除幽门螺杆菌 (Helicobacterpylori,Hp)后功能性消化不良(FD)者的症状能否得到缓解 ,阐明Hp与FD的关系。 方法 6 0例Hp感染的FD患者参加本次研究。运用改良的Glasgow评分表对患者的症状进行评分 (范围 :0～ 10分 )。所有病例随机分为三组抗Hp治疗。A组口服RBC(雷尼替丁枸橼酸铋 ) 4 0 0mg、阿莫西林 1g和呋喃唑酮 10 0mg各每日 2次。B组口服阿莫西林 1g和呋喃唑酮 10 0mg各每日 2次。C组口服RBC 40 0mg、克拉霉素 2 5 0mg和甲硝唑 40 0mg各每日 2次。总疗程均为 7d ,治疗后随访 2年。在治疗后第 4周及随访 2年后行13 C 尿素呼气试验 ,并于随访末再次对症状评分。结果 全部患者完成治疗。 42例Hp得以根除 ,18例抗Hp治疗失败。 2年后 5 4例完成复查 ,6例失访。其中 39例为Hp根除者 (39/ 5 4)。另 15例为抗Hp治疗失败者 ,其中 7例在 2年中曾自行接受追加的抗Hp治疗后为阴性 ,8例仍Hp阳性。 39例根除者中未发现复发病例。大部分的患者症状评分均有改善 ,但持续感染者评分高于根除者。在根除者中 ,平均症状评分从4.90减为 2 .38,差异有显著性 (P <0 .0 5 )。而持续感染者从 5 .0 0减至 3.0 0 ,差异无显著性 (P >0 .0 5 )。结论 通过长期随访 ,我们发现根除Hp可在较长时间内仍改?
Objective To observe whether long-term follow-up of patients with functional dyspepsia (FD) after eradication of Helicobacterpylori (Hp) can be alleviated, and to clarify the relationship between Hp and FD. Methods Sixty patients with Hp-infected FD were enrolled in this study. Patient’s symptoms were scored using a modified Glasgow scale (range: 0-10). All cases were randomly divided into three groups anti-Hp treatment. A group of oral RBC (ranitidine bismuth citrate) 400mg, amoxicillin 1g and furazolidone 10mg each 2 times a day. B group oral amoxicillin 1g and furazolidone 10mg each 2 times a day. Group C received oral RBC 40mg, clarithromycin 250mg and metronidazole 40mg twice daily. The total course of treatment was 7d, followed up for 2 years after treatment. The 13 C urea breath test was performed at 4 weeks after treatment and 2 years after follow-up. Symptoms were again scored at the end of follow-up. Results All patients completed the treatment. 42 cases of Hp were eradicated, 18 cases of anti-Hp treatment failed. Two years later, 54 cases were reviewed and 6 cases were lost. Among them, 39 were Hp eradication (39/54). The other 15 patients were those who failed the anti-Hp treatment, of whom 7 had their own additional anti-Hp treatment at 2 years and were negative, and 8 were still Hp-positive. No recurrence was found in 39 eradication cases. Most patients had improved symptom scores, but persistent infection scores were higher than eradication. In eradication, the average symptom score decreased from 4.90 to 2.38, the difference was significant (P <0.05). While the number of persistent infection decreased from 5.0 to 3.0, with no significant difference (P> 0.05). Conclusion Through long-term follow-up, we found that Hp can be eradicated in a long time.