Dikareva E.A., Matveyenko M.E., Pimanov S.I., Makarenko E.V.
Clinical, endoscopic and morphological effects of Helicobacter pylori eradication in patients with long-term use of nonsteroid anti-inflammatory drugs
Abstract.
Objectives. To conduct a prospective evaluation of clinical, endoscopic, morphological effects of Helicobacter pylori (H. pylori) eradication in patients who had been taking nonsteroid anti-inflammatory drugs (NSAIDs) for a long time.
Material and methods. The study included 116 patients with H. pylori infection. Two groups were randomly formed: in the first group (57 persons) H. pylori eradication was performed, and in the second group (59 examined patients) it was not conducted. The effects of anti- H. pylori therapy were assessed in 4-7 years after the treatment in 29 patients with successful H. pylori eradication, and in 24 people with persistent H. pylori infection.
Results. Successful H. pylori eradication after 4-7 years with constant intake of NSAIDs contributed to the reduction of pain in the epigastric region (χ2=7,20; р=0,007) and heartburn (χ2=3,95; р=0,047). The persistence of H. pylori infection after 4-7 years with constant intake of NSAIDs increased the likelihood of discomfort in the epigastric region (χ2=10,55; р=0,012) and pain (χ2=5,34; р=0,21). There were no statistically significant differences in the frequency of occurrence of erosive and ulcerative lesions of the gastroduodenal mucous membrane (MM) prior to treatment (χ2=0,01; p=0,920) and in 4-7 years (χ2=0,02; p=0,878) after it between the group of patients with successful H. pylori eradication and the group, where it was not performed. With the constant use of NSAIDs in 4-7 years after successful H. pylori eradication there was a positive dynamics of morphological indicators of gastric MM, and the preservation of H. pylori infection led to the increased MM inflammation of the stomach body and intensification of MM atrophy in the antrum and the corpus of the stomach (p<0,05).
Conclusion. Successful eradication of H. pylori infection in patients treated with NSAIDs prior to eradication therapy and constantly receiving NSAIDs thereafter, contributed to the improvement of clinical symptoms and positively influenced the morphological parameters dynamics of gastric MM, but did not affect the frequency of erosive and ulcerative lesions of the gastroduodenal zone.
Key words: nonsteroid anti-inflammatory drugs, Helicobacter pylori, eradication.
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