幽门螺旋杆菌阳性患者首次根除治疗失败后二线治疗方案的循证医学证据

Clinical Evidence for Helicobacter Pylori Positive Patient after Failure of First Eradication Therapy

幽门螺旋杆菌(HP)感染与慢性胃炎、消化性溃疡及胃癌等常见的上消化道疾病的发生密切相关,而即使使用目前最有效的根治方案,仍有约10%～20%的病人经首次治疗后仍然呈HP阳性,因此关于HP的根除治疗仍是医学界的一大难题。本文介绍有关HP感染首次根除治疗失败后的二线治疗方案的循证医学证据,以供临床参考。这些证据包括马斯特里赫特共识商讨会上提出的四联方案以及不同临床随机对照试验中更换不同种类抗生素的三联方案等。

Helicobacter pylori（HP） infection is closely associated with the occurrence of such common upper gastrointestinal diseases as chronic gastritis,peptic ulcer and gastric cancer.However,even with the currently most effective treatment regimens,approximately 10% to 20% of patients still fail to obtain eradication of the infection and remain HP positive.So the eradication of HP infection remains one of the major challenges in the medical field.This article aims to introduce the evidence for the choice of the second-line regimens after the failure of the first therapy.And the evidence includes the quadruple therapy proposed by the Maastricht III Consensus and the triple regimens with different antibiotics in all kinds of randomized clinical trials.