medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-423medsovet-9459Research ArticleЗАБОЛЕВАНИЯ ПИЩЕВОДА И ЖЕЛУДКАESOPHAGEAL AND GASTRIC DISEASESОтдаленные результаты успешной эрадикации Helicobacter pylori у пациентов с язвенной болезнью желудка (5-летнее наблюдение)Remote results of successful eradication Helicobacter pylori of patients with gastric ulcer (5-year follow-up)https://orcid.org/0000-0002-7723-7992МинушкинО. Н.MinushkinO. N.

Минушкин Олег Николаевич - д.м.н., профессор, заведующий кафедрой гастроэнтерологии.

121359, Москва, ул. Маршала Тимошенко, д. 19, стр. 1а

Oleg N. Minushkin - Dr. Sci. (Med.), Professor, Head of the Department of Gastroenterology, Central State Medical Academy of Department for Presidential Affairs of the Russian Federation.

19, Bldg. 1а, Marshal Timoshenko St., Moscow, 121359

oleg.minushkin@bk.ruhttps://orcid.org/0000-0001-6210-8955ЗверковИ. В.ZverkovI. V.

Зверков Игорь Владимирович - д.м.н., профессор кафедры гастроэнтерологии.

121359, Москва, ул. Маршала Тимошенко, д. 19, стр. 1а

Igor V. Zverkov - Dr. Sci. (Med.), Associate Professor of the Department of Gastroenterology, Central State Medical Academy of the Administrative Department of the President of the Russian Federation.

19, Bldg. 1A, Marshal Timoshenko St., Moscow, 121359

Prof.IgorZverkov@mail.ruhttps://orcid.org/0000-0002-5111-8127МасловскийЛ. В.MaslovskiiL. V.

Масловский Леонид Витальевич - д.м.н., доцент кафедры гастроэнтерологии.

121359, Москва, ул. Маршала Тимошенко, д. 19, стр. 1а

Leonid V. Maslovskii - Dr. Sci. (Med.), Associate Professor of the Department of Gastroenterology, Central State Medical Academy of the Administrative Department of the President of the Russian Federation.

19, Bldg. 1A, Marshal Timoshenko St., Moscow, 121359

lemas3@yandex.ruhttps://orcid.org/0000-0003-1201-5931ШулешоваА. Г.ShuleshovaA. G.

Шулешова Алла Григорьевна - д.м.н., профессор кафедры хирургии с курсом эндоскопии.

121359, Москва, ул. Маршала Тимошенко, д. 19, стр. 1а

Alla G. Shuleshova - Dr. Sci. (Med.), Professor of the Department of Gastroenterology, Central State Medical Academy of the Administrative Department of the President of the Russian Federation.

19, Bldg. 1A, Marshal Timoshenko St., Moscow, 121359

Shuleshova@yandex.ruЦентральная государственная медицинская академия Управления делами Президента РФРоссияCentral State Medical Academy of the Administrative Department of the President of the Russian FederationRussian Federation2025171020250154247Copyright © Минушкин О.Н., Зверков И.В., Масловский Л.В., Шулешова А.Г., 20252025Минушкин О.Н., Зверков И.В., Масловский Л.В., Шулешова А.Г.Minushkin O.N., Zverkov I.V., Maslovskii L.V., Shuleshova A.G.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/9459Введение

Введение. В международных рекомендациях Маастрихт VI определены наиболее эффективные методы диагностики и лечения язвенной болезни, ассоциированной с Helicobacter pylori (H. pylori). Изучению дальнейшего течения язвенной болезни желудка (ЯБЖ) после успешной эрадикации уделяется меньшее внимание.

Цель

Цель. Оценить влияние успешной эрадикации H. pylori на дальнейшее течение ЯБЖ.

Материалы и методы

Материалы и методы. 20 больным ЯБЖ после успешной эрадикации H. pylori тройной комбинацией препаратов ежегодно в течение 5 лет проводили ЭГДС со взятием биопсий на H. pylori, эндоскопическую рН-метрию, исследовали динамику клинической картины, уровни гастрина и соматостатина в крови.

Результаты

Результаты. За 5-летний период наблюдения выявлены рецидивы заболевания: по клиническим проявлениям – в 50% случаев (в 83% случаев из них рецидивы носили малосимптомный и бессимптомный характер), по ЭГДС – в 60% случаев (из них в 15% случаев фиксировалась язва и в 45% – эрозии желудка). Рецидив H. pylori-инфекции зафиксирован у 45% больных (из них в 15% при язве желудка и в 30% при эрозиях желудка), причем у 15% больных причиной эрозий желудка явился прием НПВС; сопровождался слабой и умеренной степенью обсемененности H. pylori и воспаления слизистой оболочки желудка (СОЖ).

Заключение

Заключение. Пятилетний период наблюдения за течением ЯБЖ после успешной эрадикации показал, что рецидивирует H. pylori в 45% случаев с изменением характера течения ЯБЖ, при этом преобладало доброкачественное течение (малосимптомное и бессимптомное), которое сопровождалось слабыми и умеренными степенями обсемененности H. pylori и воспаления СОЖ.

Introduction

Introduction. The Maastricht VI international guidelines define the most effective methods for diagnosing and treating H. pylori-associated peptic ulcer disease (PUD). Less attention has been paid to the subsequent course of PUD after successful eradication.

Aim

Aim. To evaluate the impact of successful H. pylori eradication on the subsequent course of gastric ulcer disease (GUD).

Materials and methods

Materials and methods. Twenty patients with PUD after successful H. pylori eradication with a triple drug combination underwent annual EGDS for 5 years, including H. pylori biopsies, endoscopic pH monitoring, clinical dynamics, and blood gastrin and somatostatin levels.

Results

Results. Over a 5-year observation period, disease recurrences were detected: by clinical manifestations – in 50% of cases (in 83% of cases, relapses were low-symptom or asymptomatic), by EGDS – in 60% of cases (of which ulcers were recorded in 15% of cases and gastric erosions in 45%). Recurrence of H. pylori infection was recorded in 45% of patients (of which 15% – with gastric ulcers and 30% – with gastric erosions), and in 15% of patients, the cause of gastric erosions was the use of NSAIDs; it was accompanied by weak to moderate degrees of H. pylori contamination and gastrointestinal tract inflammation.

Conclusion

Conclusion. A 5-year follow-up of PUD after successful eradication showed that H. pylori recurrence occurred in 45% of cases, with changes in the course of PUD. Benign (low-symptom and asymptomatic) recurrence was predominant, accompanied by mild to moderate H. pylori contamination and GM inflammation.

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The authors declare that there are no conflicts of interest present.