幽门螺杆菌感染治疗的现状与展望

Recent status and prospect of therapy on Helicobacter pylori infection

临床医生必须明确幽门螺杆菌 (Hp)感染根除治疗的适应证 ,并且合理、规范地应用抗生素。 1周或 2周的含铋剂、质子泵抑制剂或雷尼替丁胶体铋 (RBC)三联疗法是公认的较好方案 ,Hp根除率为 80 %～ 90 % ,1周和 2周治疗根除率无明显差异。对上述 3种治疗案无效者可采用四联疗法。Hp治疗的耐药问题突出 ,应强调规范的治疗方案 ,最好采取按地区性Hp菌株耐药性选择治疗方案的原则。在Hp根除后 6个月以上Hp检测阳性者应考虑再感染 ,但细菌DNA图谱分析法证实多数病人再感染时为同一菌株感染。

It's important to know the indication of eradicating Helicobacter pylori, as well as using antibiotics reasonably. One or two weeks' triple-therapy including bismuth citrate, proton-pump inhibitor or RBC is the best program,with the eradication rate varying from 80%～90% and no significant difference as to one or two week. But the problem of drug-resistance to anti-Hp therapy is so prominent that it's critical to use standard program of therapy. The basic rule is to choose the program concerning the drug-resistant strain of the region. If the detection of Hp is positive after 6 months' standard Hp eradication therapy,reinfection should be considered. The analysis of bacteria DNA atlas confirms that most of the cases had reinfection of the same strain.