胃潰瘍と十二指腸潰瘍における再発因子としてのHelicobacter pyloriの重要度

The Importance of Helicobacter pylori Eradication in Prevention of Duodenal and/ or Gastric Ulcer Relapse

要旨　Heliobacter pylori(H. pylori)を除菌した147例の胃・十二指腸潰瘍患者の再発につき検討した．経過観察期間は平均24か月(6～55か月)で，H. pyloriの再陽性化とNSAIDs潰瘍を除いたH. pylori持続陰性非NSAIDsの再発は5.4％(8/147)であった．除菌後から再発までの平均期間は2.6か月で，そのほとんどが1か月以内の再発であり，10か月以降の再発はみられなかった．すなわち，除菌後およそ1年以降の潰瘍再発は極めてまれで，除菌により長期間，潰瘍の再発が抑制されることが明らかとなり，H. pylori除菌の重要性が確認された．しかし，除菌後早期に潰瘍の再発が起こる機序は明らかでなく，今後の解明が待たれる．

　We examined endoscopically duodenal and/or gastric ulcer relapse in 147 patients (94M/53F, mean age 52 yr) after Helicobacter pylori (H. pylori) eradication. The mean follow-up period was 24 months (6～55 months). The H. pylori recurrence rate was 2% (1%/year). The total ulcer relapse rate was 8.8% (13/147). When relapse cases associated with NSAIDs and reinfection of H. pylori were excluded for analysis, the relapse rate was 5.4%. All duodenal and gastric ulcers relapsed between 1 to 9 months (mean 2.6 months) after eradication, while no relapse was found after one year of eradication. It is still unknown why duodenal and gastric ulcers frequently relapse within a short period after eradication.