RESUMEN
BACKGROUND AND METHODS: Upper endoscopy records from 1998 to 2003 were reviewed. The demographic data, endoscopic diagnosis, results of rapid urease test and the absence or presence of intestinal metaplasia (IM) in histology were reviewed, to evaluate the prevalence of IM and Helicobacter pylori (Hp) infection over time in Hong Kong. RESULTS: Among 1805 endoscopies performed, 1751 had both rapid urease test and histology available. A significant drop in the prevalence of duodenal ulcers from 17.9% in 1998 to 9.8% in 2003 was found (P = 0.015). Prevalence of IM was 13.9%, 5.9% and 9.4% in Hp positive, Hp negative and overall respectively (P < 0.05). The prevalence of IM increased with age, and the patterns were similar amongst subjects in 1998-2000 and those in 2001-2003. There was progressive decrease in Hp prevalence from 58% in 1998 to 40% in 2001 (P = 0.014), but no further decrease was seen in 2002-3. There was no corresponding decrease in IM prevalence. Instead IM prevalence in 2002-2003 was significantly higher than the prevalence in previous few years (P = 0.04). CONCLUSION: The prevalence of IM did not change in the period from 1998 to 2003 despite a drop in the prevalence of Hp infection since 1994.
Asunto(s)
Neoplasias Esofágicas/epidemiología , Infecciones por Helicobacter/epidemiología , Helicobacter pylori/patogenicidad , Lesiones Precancerosas/epidemiología , Neoplasias Gástricas/epidemiología , Úlcera Gástrica/epidemiología , Adolescente , Adulto , Distribución por Edad , Factores de Edad , Anciano , Anciano de 80 o más Años , Pruebas Respiratorias , Úlcera Duodenal/epidemiología , Úlcera Duodenal/microbiología , Úlcera Duodenal/patología , Endoscopía Gastrointestinal , Neoplasias Esofágicas/microbiología , Neoplasias Esofágicas/patología , Esofagoscopía , Femenino , Infecciones por Helicobacter/microbiología , Infecciones por Helicobacter/patología , Hong Kong/epidemiología , Humanos , Masculino , Metaplasia , Persona de Mediana Edad , Lesiones Precancerosas/microbiología , Lesiones Precancerosas/patología , Prevalencia , Distribución por Sexo , Factores Sexuales , Neoplasias Gástricas/microbiología , Neoplasias Gástricas/patología , Úlcera Gástrica/microbiología , Úlcera Gástrica/patología , Factores de Tiempo , Adulto JovenRESUMEN
BACKGROUND: Rabeprazole in combination with amoxicillin and metronidazole (RAM) has been shown to be an effective second-line treatment of Helicobacter pylori infection. The effects were compared of 7-day low-dose and high dose rabeprazole in RAM for the primary treatment of H. pylori infection in Chinese patients. METHODS: Helicobacter pylori-positive dyspeptic patients were randomized to receive either (i) rabeprazole 10 mg, amoxicillin 1000 mg and metronidazole 400 mg (RAM-10) or (ii) high-dose rabeprazole 20 mg, amoxicillin 1000 mg and metronidazole 400 mg (RAM-20), each given twice daily for 7 days. Helicobacter pylori eradication was confirmed by (13)c-urea breath test 5 weeks after stopping medications. side-effects of treatments were documented. RESULTS: A total of 120 patients were eligible for analysis. By intention-to-treat and per-protocol analysis, the eradication rates were 83% and 86% in the RAM-10 group and 75% and 76% in the RAM-20 group, respectively (P = 0.26 and P = 0.17). Both regimens were well-tolerated and compliance was >98% in both groups. CONCLUSIONS: Low-dose rabeprazole in combination with amoxicillin and metronidazole is an effective, economical and well-tolerated therapy for the treatment of H. pylori infection in Chinese population.