内镜表现的相关性分析和Helicobacter pylori的根除作用
1Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Frontiers in medicine
|September 14, 2023
概括
消除Helicobacter pylori (H. pylori) 是预防胃癌的关键. 老年和特定的内镜发现,如多个白色的平面病变,阻碍了H. pylori的根除,而扩散的红色可能有助于它.
科学领域:
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
- 在瘤学瘤学.
背景情况:
- 杆菌 (H. pylori) 感染是胃癌的主要危险因素.
- 成功根除H. pylori可降低胃癌的发生率和死亡率.
- 抗生素耐药性增加和根除率下降需要了解影响治疗成功的因素.
研究的目的:
- 调查内镜表现和H. pylori根除疗法的有效性之间的相关性.
- 为了确定与H. pylori根除失败相关的特定内镜检测结果.
- 为 H. pylori 感染提供个性化的治疗策略.
主要方法:
- 在2022年1月至2023年3月期间,对323名因H. pylori感染而接受治疗的门诊患者进行了回顾性分析.
- 使用13C尿素呼吸试验进行诊断和根除确认.
- 对基于PPI的四重治疗结果的临床特征和内镜发现的分析.
主要成果:
- 最初的H. pylori根除率为82.0%.
- 与根除失败显著相关的因素包括年龄 (60岁以上),扩散的红色,多个白色和平面升高的病变和缩.
- 多变量分析确定60岁以上的年龄和多个白色/平面升高的病变是根除失败的独立风险因素,而扩散的红色是保护因素.
结论:
- 60岁以上的年龄和特定的内镜检查结果 (多个白色,平面升高的病变) 是初始H. pylori根除失败的独立风险因素.
- 在内镜检查期间观察到的扩散红色可能是H. pylori根除的保护因素.
- 建议考虑对有风险因素的患者进行药物敏感性测试或耐药性基因突变检测,等待进一步研究.
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