ABSTRACT
Objective To investigate the incidence of peptic ulcer (duodenal ulcer and gastric ulcer) and the development of Helicobacter pylori (Hp) infection in the population during 10 years after Hp eradication.Methods Subjects were chosen from general population and performed endoscopy.Among them,the individuals confirmed to be Hp positive were randomly divided into treatment group and placebo group.The patients in treatment group received OAC triple therapy (omeprazole 20 mg,clarithromycin 500 nag and amoxicillin 1000 re.g,twice daily) for one week.After that,both groups continuously followed up by endoscopy during at 1st,5th,8th and 10th year for incidence and relapse of peptic ulcer as well as status of Hp infection.The patients in treatment group were examined by 13C-UBT for Hp eradication one month after the completion of treatment.Results At the 1st year,the incidence of peptic ulcer between the treatment group and placebo group were 3.7% and 12.85% (P=0.0002),respectively.At the 5th year,they were 5.86% and 14.93% (P=0.0017),respectively.At the 8th year,they were 4.4% and 9.39% (P = 0.044),respectively.The incidence of peptic ulcer of the treatment group significantly decreased after the eradication therapy compared to the placebo group.After the eradication,at the 1st year,the recurrence rates were 3.70% and 38.1% between the treatment group and the placebo group (P=0.0027).At the 5th year,they were 14.81% and 42.86% (P=0.03).At 8th year,they were 14.81 and 47.62% (P=0.03),respectively.At the 10th year,they were 25.93% and 57.14% (P=0.028).Then the recurrence rates of the treatment group significantly decreased compared to the placebo group.During the 10-year follow up study,the rate of Hp reinfection after a successful eradication in the treatment group was high,and it was 46.4% at the 10th year.Conclusion Both the incidence and recurrence of peptic ulcer significantly decreased after Hp eradication.It is necessary of Hp eradication in patients with peptic ulcer.Hp reinfection after a successful eradication is more frequent.
ABSTRACT
Objective To evaluate the protective effects of hydrotalcite,Marzulene-s,selbex,gefarnate,sucralfate and rebamipide against the gastric mucosa lesions induced by ethanol,aspirin,hydrochloric acid or prednisolone in rats.The changes in intercellular space width of gastric epithelial in rats was observed. Methods Four kinds of models were used to observe the protective effects of six agents against the gastric mucosal lesions.① Ethanol model:a total of 84 male Wistar rats were divided into 7 groups with 12 each. The rats in group 1 to 7 were orally received hydrotalcite,Marzulene-S,gefarnate,sucralfate,rebamipide or normal saline for 3 days,respectively.On day 4,the rats were given 1 ml of absolute ethanol.The length of gastric lesion were measured by ulcer index.② Aspirin model:the rats were received 300 mg/kg of aspirin and 0.1 mol/L hydrochloric acid (0.5 ml/100 g).The following procedures were as ①.③ Hydrochloric acid model:the rats were received 1 ml of 0.7 mol/L hydrochloric acid. The following procedures were as ①. ④ Prednisolone model: all groups were administrated with above 6 agents or normal saline for 5 days.During the 2nd-5th day,the rats were subcu aneously injected with prednisolone (250 mg/kg) daily. Rats were killed on 5th day,and the lesions were mcasured by ulcer index.Gastric mucosal tissue of No.1,5 and ]0 rat in the control group and the hydrotalcite group were picked up to measure the intercellular space width using transmission electron microscopy. Results In four kind of models,the ulcer index were significantly lower in rats treated with mucosal protective agents than that in the controls (P＜0.05),expecially in hydrotalcite group (P＜0.01).The width of intercellular space in the hydrotalcite group was significantly narrower than that in controls (P＜0.05).Conclusions All of the mucosal protective agents can be against the gastric mucosal lesion induced by ethanol,hydrochloric acid,aspirin or prednisolone.Among them,the hydrotalcite is even better.The effect of hydrotalcite is further confirmed by observation of intercellular space width.