幽门螺杆菌根除疗法对肠道微生态的影响

Effects of Helicobacter pylori eradication therapy on gut microflora

幽门螺杆菌(Helicobacter pylori)感染是世界范围关注的焦点,进行幽门螺杆菌根除治疗是世界各国针对感染所采取的一项重要举措。但随着幽门螺杆菌耐药率,尤其是对大环内酯类药物耐药率的增加,标准三联疗法根除效果逐渐不能满足需求,更多的疗法得以推出。但是新推出的诸多疗法都应用了比以前更大剂量、更多种类甚至更长疗程的抗生素,这对于肠道微生物的微生态结构和数量都可能造成严重影响,甚至可能产生严重的副作用,同时也可能会对其耐药性产生影响。本文回顾了近20年来幽门螺杆菌根除治疗对肠道微生态的影响和一些新型实验疗法的研究结果,以对上述问题进行探讨。

The infection of Helicobacter pylori is increasingly drawing the world＇s attention, and the radical treatment is the main measure taken by most countries aiming to reduce the rate of infection and subsequent health problems such as peptic ulcer, gastritis and gastric cancer. However, with the increase of drug resistance, especially the increase of macrolide drug resistance, the standard triple therapy is losing its power in controlling the bacteria and new therapies are in urgent need. But most of the new therapies use a longer course, a larger dose and a wider range of antimicrobial agents, and thus can bring severe influences on the structure and quantity of the gut microflora, which may result in severe side effects. Moreover, the deteriorating situation of the antimicrobial resistance will be exacerbated. This review summarized researches in the recent 20 years focusing on the effects that the eradication therapy may bring to the gut microflora. We also summarized some new experimental therapies, thus try to draw a clear profile of our current situation and give some clues for the treatment of Helicobacter pylori.