幽门螺杆菌感染治疗的现状、问题及对策

Present situation,problems and countermeasures in the treatment of Helicobacter pylori infection

幽门螺杆菌(Hp)的发现被视为现代消化疾病研究的一个里程碑。现已明确Hp感染是慢性胃炎、消化性溃疡的主要病因,与胃癌和胃黏膜相关性淋巴样组织(MALT)淋巴瘤的发病也密切相关。现今的Hp感染治疗方案是以抗生素联合应用铋剂和(或)质子泵抑制剂(PPI)的"三联"或"四联"疗法,但由于患者的依从性、药物的不良反应、费用-效益比、停药后的复发和再感染,特别是Hp耐药菌株的迅速增多等问题的存在使其应用范围受限。现就Hp感染治疗现状和问题以及Hp耐药问题的对策进行阐述。

Finding of Helicobacter pylori （Hp） should be regarded as one of the notable landmarks in the modern study of digestive disease. Hp is associated with gastro-intestinal illnesses such as gastritis, peptic ulcer, gastric cancer and gastric mucosa-associated lymphoid tissue （MALT） lymphoma. Although significant progress has been made in treating Hp infection with current triple or quadruple therapy based on antibiotics combined with bismuth compounds and （or） proton pump inhibitors （PPI）, the limitations of pharmacological therapy such as the poor compliance, the side effects, the high cost, the high recurrence rate, and most importantly, the rapid emergence of antibiotic resistance have set the stage for the development of less costly and more efficient means to prevent and control Hp infections. This article reviews the current situation and problems and countermeasures of drng-resistance in the treatment of Hp infection.