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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Prevalence of Helicobacter Pylori Infection and Stress, Anxiety or Depression in Functional Dyspepsia and Outcome after Appropriate Intervention VC11-VC15
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Prevalence of Helicobacter Pylori Infection and Stress, Anxiety or Depression in Functional Dyspepsia and Outcome after Appropriate Intervention VC11-VC15

机译：适当干预VC11-VC15后幽门螺杆菌感染的流行和功能性消化不良的应激，焦虑或抑郁和结果

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Introduction: The association between psychological factors and non-ulcer dyspepsia remains controversial.Aim: To determine the prevalence of Helicobacter pylori (HP) and Stress/Anxiety/Depression (SAD) in patients with Functional Dyspepsia (FD) and assess the outcome at three months after appropriate intervention.Materials and Methods: This prospective non-randomized interventional study was conducted on 120 patients with FD. Initial workup included upper gastrointestinal endoscopy to confirm HP infection with either of two tests, the urease test or histopathology. Patient Health Questionnaire-9 scale (PHQ-9) was used to assess depression, General Anxiety Disorder-7 scale (GAD-7) for anxiety and Perceived Stress Scale (PSS) for stress. Patients were considered positive when they had significant scores on one or more of the questionnaires (SAD+). The subjects were then classified into four groups: Group A (positive for HP and SAD, n=35), Group B (positive for HP and negative for SAD, n=31), Group C (negative for HP and positive for SAD, n=33) and Group D (negative for HP and SAD, n=21). The groups were then treated as follows: Group A: HP eradication plus psychiatric intervention, Group B: HP eradication alone, Group C: psychiatric intervention alone and Group D: proton pump inhibitors. Modified Glasgow Dyspepsia Symptom Score (Mod. GDSS) was used to assess the severity of dyspepsia at baseline and to monitor the change in score over three months. Statistical analysis was done using the Statistical Package for the Social Sciences version 16.0. Non-parametric data like proportions of response in different groups to treatment was analysed using the Chi square test and quantitative data using ANOVA. Gender wise distribution and response to treatment was calculated using the z-test and unpaired t-test.Results: Overall 120 patients were recruited across four groups. A 55% of the subjects were positive for HP and 56.7% for SAD and 29.2% for both. In all three groups with psychiatric comorbidity, females exceeded males in a proportion of 3:1. Mod. GDSS was not significantly different at baseline between HP+ and HP- patients (p=0.1278) except when HP positivity was also associated with SAD (p<0.001), whereas SAD positivity alone significantly increased the baseline Mod. GDSS (p=0.006). Mod. GDSS declined in all four groups at three months. When a fall of four or more was considered as an indicator of significant response to intervention, it was seen that overall 74.2% responded to intervention with the best response in Group B and the poorest was in Group C.Conclusion: There is a significant prevalence of HP and SAD in FD. Appropriate intervention is beneficial except in those who are HP negative and SAD positive. This latter group requires further investigation and or drug intervention for SAD.
机译：简介：心理因素与非溃疡性消化不良之间的关联仍存在争议。目的：确定功能性消化不良（FD）患者的幽门螺杆菌（HP）和压力/焦虑/抑郁（SAD）患病率并评估三项结局材料和方法：这项前瞻性非随机干预研究是对120例FD患者进行的。最初的检查包括上消化道内窥镜检查，以尿素酶检测或组织病理学两种检测方法确认HP感染。使用患者健康问卷9量表（PHQ-9）评估抑郁症，使用一般焦虑症7量表（GAD-7）评估焦虑，使用感知压力量表（PSS）评估压力。当患者在一项或多项调查表（SAD +）上的得分较高时，被认为是阳性的。然后将受试者分为四组：A组（HP和SAD阳性，n = 35），B组（HP阳性和SAD阴性，n = 31），C组（HP阴性和SAD阳性， n = 33）和D组（HP和SAD为负，n = 21）。然后按以下方式对各组进行治疗：A组：根除HP加精神病干预; B组：仅根除HP; C组：仅精神病干预; D组：质子泵抑制剂。改良的格拉斯哥消化不良症状评分（Mod。GDSS）用于评估基线时消化不良的严重程度，并监测三个月内评分的变化。使用“社会科学统计软件包” 16.0版进行统计分析。使用卡方检验分析非参数数据，例如不同组对治疗的反应比例，并使用方差分析分析定量数据。使用z检验和未配对的t检验计算了按性别划分的性别和对治疗的反应。结果：总共从四组中招募了120名患者。 55％的受试者的HP阳性，SAD的阳性率为56.7％，两者均为29.2％。在所有三个患有精神病合并症的人群中，女性以3：1的比例超过男性。 Mod。在HP +和HP-患者之间，基线时的GDSS没有显着差异（p = 0.1278），除非HP阳性也与SAD相关（p <0.001），而单独的SAD阳性显着增加了基线Mod。 GDSS（p = 0.006）。 Mod。三个月后，所有四个组的GDSS均下降。当认为四分之三或更多下降是对干预措施有明显反应的指标时，可以看出，总体上有74.2％的患者对干预措施的反应在B组中反应最好，而在C组中最差。 FD中的HP和SAD。适当的干预是有益的，除了那些HP阴性和SAD阳性的患者。后一组需要进一步调查和/或对SAD进行药物干预。

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