老年幽门螺杆菌感染根除治疗进展

Progress in eradication of Helicobacter pylori infection in the elderly with Traditional Chinese and Western Medicine

幽门螺杆菌(Helicobacter pylori, Hp)是Ⅰ类致癌因子。抗生素耐药率高、感染率高、耐受性低的特点限制着常规一线抗Hp治疗在老年人群中的应用。老年患者根除Hp可显著降低消化道肿瘤与消化道出血发生的风险,治疗获益确切。目前老年Hp根除的主要方案仍为铋剂四联疗法,加载益生菌或中药可提高根除率、减少不良反应。高剂量二联疗法以其不良反应风险小、疗效肯定的优势或可成为老年Hp根除治疗的另一理想方案。

Helicobacter pylori(Hp)is an I-type carcinogenic factor.High antibiotic resistance,high infection rate,and low tolerability of eradication therapy in the elderly Hp-infected population limit the use of conventional first-line therapy in the elderly population.The eradication of Hp in elderly patients can still benefit by significantly reducing the incidence of gastrointestinal tumors and the risk of gastrointestinal bleeding.The current primary regimen for Hp eradication in the elderly remains bismuth quadruple therapy,with the loading of probiotics or Traditional Chinese Medicine treatment to improve eradication rates and reduce adverse effects.High-dose dual therapy may be another ideal option for Hp eradication in the elderly due to its low risk of adverse effects and definiteefficacy.