Helicobacter pylori negative peptic ulcer and ulcer bleeding:a multi-center case-control study in China mainland
10.3760/cma.j.issn.1007-5232.2010.08.006
- VernacularTitle:幽门螺杆菌阴性消化性溃疡与出血关系的多中心对照研究
- Author:
Pingping DIAO
;
Yiqi DU
;
Zhaoshen LI
;
Shude LI
;
Jianchang SHU
;
Ximei CHEN
;
Zhongjie ZHOU
;
Heping LU
;
Huiqing JIANG
;
Xishuang LIU
;
Lin LU
;
Li YANG
;
Zhaohong SHI
;
Pengfei LIU
;
Huiming TU
;
Guochang CHEN
;
Zhijian ZHANG
- Publication Type:Journal Article
- Keywords:
Hemorrhage,peptic ulcer;
Helicobacter pylori
- From:
Chinese Journal of Digestive Endoscopy
2010;27(8):410-414
- CountryChina
- Language:Chinese
-
Abstract:
Objective The primary aim of this study was to examine the proportion and natural history of Helicobacter pylori (Hp) negative bleeding peptic ulcers. Methods The study was designed as a multiple-center, case-control study conducted in 14 endoscopy centers in China from April 2006 to March 2007. Each center was expected to recruit 30 peptic ulcer patients with bleeding ( PUB group) and 30 without (PU group). All screened patients with upper gastrointestinal bleeding received endoscopy within 24 hours of admission. Biopsy specimens were taken from the antrum to determine Hp infection by rapid urease test and pathology. Patients with negative Hp infection at first examination were asked to receive urease breathe test (UBT) one month later. Results A total of 617 patients were enrolled with 263 in PUB group and 354 in PU group. There is no significant difference in demographic characters between 2 groups ( P ＞0. 05). The rate of Hp infection in PUB group ( 161/263, 61.2% ) was significantly lower than that in PUgroup (311/354, 87. 9%, P ＜0. 001 ). The incidence of complex ulcer in Hp positive PUB patients was 7.5% ( 12/161 ), which is significantly higher than that in Hp negative PUB patients ( 1/102, 1.0% , P =0. 018). In PUB group, no significant differences were found between Hp positive and negative patients in regarding of age, sex, rates of haematemesis, duodenal ulcer and gastric ulcer, and size of ulcer ( P ＞0. 05 ). Among 102 Hp negative cases in PUB, no positive case was found in UBT one month later. Conclusion We have demonstrated a rise in the incidence of Hp negative bleeding ulcers in China. The idiopathic ulcer was not rare, and might have a higher tendency to cause bleed.
