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Helicobacter pylori infection in bleeding peptic ulcer patients after non-steroidal antiinflammatory drug consumption

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World Journal of Gastroenterology 2011年第40期17卷 4509-4516页

作者： Francesco Manguso Elisabetta Riccio Germana de Nucci Maria Luisa Aiezza Gerardino Amato Linda Degl'Innocenti Maria Maddalena Piccirillo Gianfranco De Dominicis Tara Santoro Elena Trimarco Antonio Balzano Complex Operating Unit of Gastroenterology AORN A Cardarelli 80131 Napoli Italy Complex Operating Unit of Pharmacy AORN A Cardarelli 80131 Napoli Italy Complex Operating Unit of Microbiology AORN A Cardarelli 80131 Napoli Italy Complex Operating Unit of Pathology AORN A Cardarelli 80131 Napoli Italy

AIM： TO establish the prevalence of He/icobacterpy/on （H. pylori） infection in patients with a bleeding peptic ulcer after consumption of non-steroidal antiinflammatory drugs （NSAIDs）.METHODS： A very early upper endoscopy was performed to find the source of upper gastrointestinal bleeding and to take biopsy specimens for analysis of H. pylori infection by the rapid urease （CLO） test, his- tological examination, and bacterial culture. TgG anti- CagA were also sought. The gold standard for identifying H. pylori infection was positive culture of biopsy specimens or contemporary positivity of the CLO test and the presence of H. pylori on tissue ***： Eighty patients, 61 males （76.3%）, mean age 61.2 ~ 15.9 years, were consecutively enrolled. Forty-seven （58.8%） patients occasionally consumed NSAIDs, while 33 （41.3%） were on chronic treatment with low-dose aspirin （LD ASA）. Forty-four （55.0%） patients were considered infected by H. pylori. The infection rate was not different between patients who occasionally or chronically consumed NSAIDs. The culture of biopsy specimens had a sensitivity of 86.4% and a specificity of 100%; corresponding figures for histological analysis were 65.9% and 77.8%, for the CLO test were 68.2% and 75%, for the combined use of histology and the CLO test were 56.8% and 100%, and for IgG anti-CagA were 90% and 98%. The high- est accuracy （92.5%） was obtained with the culture of biopsy ***： Patients with a bleeding peptic ulcer after NSAID/LD ASA consumption frequently have H. pylori infection. Biopsy specimen culture after an early upper gastrointestinal tract endoscopy seems the most efficient test to detect this infection.

关键词： Helicobacter pylori Helicobacter pylori in-fection Low-dose aspirin non-steroidal antiinflamma-tory drugs Peptic ulcer hemorrhage Endoscopy

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