根除幽门螺杆菌对患者胃肠道微生态影响的研究现状及进展

Progress in understanding of impact of Helicobacter pylori eradication on gastrointestinal microecology

幽门螺杆菌(Helicobacter pylori,H.pylori)为临床常见慢性感染之一,Maastricht V共识及京都共识均强调了对感染患者实施H.pylori根除治疗的必要性,推荐的根治治疗方案包括铋剂、质子泵抑制剂(proton pump inhibitors,PPIs)、四联抗生素根除等,疗程为10 d或14 d.临床研究已明确抗生素治疗和PPIs治疗会对肠道微生态产生影响,尤其在短期内影响显著;然而在根除H.pylori后6 mo内相关研究仍相对缺乏.为了改善H.pylori根除治疗的长期安全性,一些学者建议在根除方案中添加益生菌以减少肠道微生态波动并维持稳定状态,但仍需要进一步深入探讨该方法的有效性.为指导临床治疗,本文以H.pylori根除治疗对患者胃肠道微生态影响的研究现状及进展作一综述.

Helicobacter pylori(H.pylori)infection is a prevalent chronic condition commonly encountered in clinical practice.Both the Maastricht V Consensus and the Kyoto Consensus emphasize the imperative of implementing eradication therapy for patients infected with H.pylori.Recommended treatment options encompass bismuth agents,proton pump inhibitors(PPIs),and quadruple antibiotic eradication regimens,typically administered for a duration of either 10 or 14 d.Clinical studies have confirmed that both antibiotic therapy and PPI therapy can exert an impact on the intestinal microecology,particularly in the short term.However,there remains a relative dearth of research within 6 months following H.pylori eradication.To enhance the long-term safety of H.pylori eradication therapy,some scholars propose incorporating probiotics into the eradication regimen to mitigate fluctuations in intestinal microecology and maintain a stable state;nevertheless,further exploration is still required to ascertain the efficacy of this approach.This article comprehensively reviews the current research progress regarding the impact of H.pylori eradication on gastrointestinal microecology,in order to provide guidance for clinical treatment of H.pylori infection.