| Objective: Helicobacter plori(H.pylori)gastritis is defined as a kind of infectious disease both at Kyoto global consensus report about Helicobacter pylori gastritis and Maastricht V consensus report about the management of H.pylori infection,which may transmit from mouth to mouth or from fecal to mouth.The rate of H.pylori re-infection is different as different countries and regions.There is a lack of the bulk of cases reports at present,and no research on the rate of H.pylori re-infection and its influencing factors in Hebei region.This study aims to explore the rate of H.pylori re-infection and its influencing factors at Shi Jia zhuang city in Hebei province,and provides an effective reference for more reasonable treatment of patients.Method:1 Patient selectionA total of 350 patients who were identified with H.pylori eradication successfully from June 2010 to June 2016 were selected.There are 184 female patients and 166 male patients,whose average age is(45.07±12.02).1.1 Inclusion Criteria:(1)At the age of between 18 and 70,and conduct the rapid urease test(RUT)or the 13C-urea breath test(13C-UBT)or 14C-urea breath test(14C-UBT)after successful eradication.(2)The reviewer by follow-up time after successful eradication;(3)the patients after treatment who meet one of the following conditions were considered to be eradicate successful:(1)13C-urea breath test or 14C-urea breath test was negative;(2)the rapid urease test in the gastric antrum and gastric body were negative for H.pylori [1].(4)All the patients were informed and consent before enrolling the study protocol,approved by the ethics committee of the Third Hospital of Hebei Medical University.1.2 Exclusion criteria:(1)Patients with serious damage to heart,lung,liver and kidney function.(2)Patients with malignant tumor.(3)Patients who were more than 1 times of H.pylori eradication or antibiotic therapy within 1months.(4)Patients who had taken antibiotics and bismuth in the past 4 weeks or taken a proton pump inhibitor within 2 weeks.(5)Patients with a history of subtotal gastrectomy.(6)Those who failed to follow up after successful eradication.2 Method2.1 Test method:According to the time of follow-up,350 cases of H.pylori patients included in the study after success eradication,were carried out the RUT or 13C-UBT or 14C-UBT.The positive rate within 1 years after successfully eradicated and the rate of H.pylori re-infection after one year was observed.The patients after one year were divided into two groups,which were the H.pylori re-infection group and the persistenting keep the negative group,and then the influence factors of re-infection were analyzed.2.2 Record patient dataRecord the patient's name,gender,age,smoking,drinking,education,home address,family income,exposure;The detected result of H.pylori in 6months,6 months to 1 years,1 years to 2 years,2 years-3 years,3 years-4years,4 years to 5 years,5 years to six years.2.3 Statistical methods: The SPSS21.0 software was used to analyze the data,and the count data was expressed as a percentage.The ?2 test was used to compare the re-infection rate,and the difference was statistically significant when P<0.05.The Nonparametric Rank Sum Test was used when the variance of the measurement data was not complete,and the difference was statistically significant when ? =0.05 and P<0.05;the Binary Logistic Regression Analysis was used to analyze the influencing factors,and it's a risk factor when B>0and OR>1,and the difference was statistically significant when P<0.05.Result:1.1 There was no case of the 350 patients after successful eradication lost,and the follow-up response rate was 100% in the first year;a total of 327 patientswho were maintained an H.pylori-eradicated state at 1 year after eradication were followed up for 5 years,in the second year a total of 4 cases were lost,and the follow-up response rate was 98.77%;in the third year a total of 10 cases were lost,and the follow-up response rate was 96.94%;in the fourth year a total of 18 cases were lost,and the follow-up response rate was 94.49%;in the fifth year a total of 23 cases were lost,and the follow-up response rate was 92.66%;a total of 28 cases were lost,the follow-up response rate was91.43% in the sixth year.1.2 The incidence of re-infection after H.pylori successful eradicationThe incidence of infection after H.pylori successful eradication was shown as Table1 and Table2,During the followed up for six months,six months to one year,there were 23 cases were positive of H.pylori,of which there were 14 cases within six months,and there were 9 cases from six months to one year in the patients with H.pylori,the cumulative(six months)the positive rates were respectively 4% and 6.68%(2.68%);follow up period from second to sixth year,there were 13 H.pylori positive cases,each year was respectively,5case,3case,2case,2case,1case.the re-infection cumulative(each year)rates were respectively 1.53% ? 2.47%(0.94%)? 3.12%(0.65%)?3.79%(0.67%)? 4.13%(0.34%),by Chi Square Test P>0.05,the five years re-infection rate had no significant difference;the follow-up of six months,six months to the first year of re-infection rate is higher than the follow five years(P<0.05).Thus,even if had been successful eradicated H.pylori infection,people can re-infected,H.pylori re-infection rate was very low,the positive rates of H.pylori infection are higher within one year than the follow each years.The rate of re-infection of the each year during five years remained relatively stable,which is 0.83%.1.3 Influencing factors of H.pylori re-infection rate: single factor analysis:The age of the patients distributed in 18~31,32~45,46~57,58~70.There was no significant difference in the age distribution of H.pylori re-infection(P=0.383),there was no significant difference in the gender of H.pylori re-infection(P=0.074),there was no significant difference in the smoking of H.pylori re-infection(P=0.718),there was no significant difference in the drinking of H.pylori re-infection(P=0.064),there was no significant difference in the level of education of H.pylori re-infection(P=0.565),there was no significant difference in residence of H.pylori re-infection(P=0.094),there was no significant difference in education of H.pylori re-infection(P=0.001),there was significant difference in Monthly family income of H.pylori education of re-infection(P=0.047)(shown as Table3),11 of 13 reinfection patients with the exposure factors(84.7%),the level of family monthly income <5000 RMB accounted for 10 cases(69.2%).The Multivariate factors analysis of re-infection rate: after two Logistic regression analysis,we found that exposure factors and monthly family income were the risk factors of re infection(P<0.05,B>0,OR>1)(shown as Table4).Conclusion:1 It's possible to be re-infected H.pylori after successful eradication,and the re-infection rate was low as 0.83%.The re-infection rate was relatively stable within 5 years.2 Exposure factors and low monthly family income were risk factors for H.pylori re-infection. |
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