条文本
摘要
背景:人们对无创幽门螺杆菌检测作为消化不良患者预测诊断和确定治疗的一种手段很感兴趣。目的:评估14C尿素呼气试验作为消化性溃疡患者出现消化不良的预测指标的价值。患者和方法:连续327例消化不良患者在内窥镜检查前进行14C尿素呼气试验。不包括先前确诊患有溃疡、以前做过胃手术或正在服用非甾体类抗炎药的患者。结果:在182例14C尿素呼气试验阳性的患者中,45%出现十二指肠溃疡和/或胃溃疡,另外2%出现糜烂性十二指肠炎。12%的呼吸试验阳性患者存在食管炎,三分之二的食管炎患者同时存在溃疡。幽门螺杆菌阳性消化不良患者溃疡患病率与吸烟和既往调查状况独立相关。如果之前未进行调查,那么吸烟者的溃疡患病率为67%,非吸烟者为46%。如果之前的上消化道检查结果为阴性,则吸烟者溃疡患病率为53%,非吸烟者为28%。在136名呼吸试验呈阴性的患者中,只有5%患有消化性溃疡。 The most frequent endoscopic finding in these H pylori negative subjects was oesophagitis, being present in 17%. CONCLUSIONS: This study demonstrates that a positive H pylori test is a powerful predictor of the presence of underlying ulcer disease in dyspeptic patients, especially if smokers, and that a negative H pylori test is a powerful predictor of the absence of ulcer disease. It also indicates that a negative upper gastrointestinal investigation does not preclude subsequent presentation with ulcer disease.