1999年幽门螺杆菌若干问题的共识意见发表3年后的调查报告

A Survey Three Years after the Publication of 1999 Chinese Consensus on the Management of Helicobacter pylori Infection

背景:我国为幽门螺杆菌(H.pylori)感染高发地区。1999年制定的H.pylori若干问题的共识意见有助于临床医师正确诊治H.pylori感染患者。目的:了解共识意见发表3年后我国临床医师如何处理H.pylori感染。方法:设计由16个问题组成的问卷调查表,在中华医学会消化病学分会网站和医学空间网站上公布。结果:共收到合格答卷511份,57.1％的医师经常检查H.Pylori感染。常用的检测方法是:快速尿素酶试验(RUT)60％,尿素呼气试验(UBT)40％,组织病理学检查36％。治疗H.pylori感染时,74.5％的医师选择三联疗法,19.0％选择四联疗法,5.7％选择二联疗法。50％的医师选用质子泵抑制剂(PPI)+两种抗生素,41％选用铋剂+两种抗生素,34％选用H_2受体阻滞剂(H_2RA)/PPI+铋剂+两种抗生素,14％选用雷尼替丁枸橼酸铋(RBC)+两种抗生素;45％的医师选用呋喃唑酮。93％的医师认为H.pylori耐药是一严重问题。95％的医师选用四联疗法作为补救治疗,或更换更敏感的药物,或增加抗生素的剂量和疗程。83％的医师根除治疗后复查H.pylori感染情况。52％的医师获取诊治H.Pylori感染相关信息的来源为1999年H.pylori处理共识意见。结论:共识意见对临床医师正确处理H.pylori感染起重要作用。

Background: The prevalence of Helicobacter pylori (H. pylori) infection is very high in China. The 1999 Chinese Consensus on the management of H. pylori infection has helped the clinicians to diagnose and treat the patients with H. pylori infection correctly. Aims: To survey the impact of 1999 Chinese Consensus 3 years after the publication, and the management of H. pylori infection by Chinese clinicians. Methods: A questionnaire containing 16 questions was published in the websites of Chinese Society of Gastroenterology and Medcyber. Results: Five hundred and eleven doctors were randomly recruited to answer the questionnaire. 57.1% of doctors routinely tested for H. pylori infection. The tests often used were: rapid urease test (RUT) 60%, urea breath test (UBT) 40%, histopathology 36%. 74.5% of doctors used triple therapy, 19.0% quadruple therapy and 5.7% dual therapy. 50% of doctors used proton pump inhibitor (PPI)-based triple regimens, 41% used bismuth-based triple regimens, 34% used H_2 receptor antagonist (H_2RA)/PPI and bismuth with 2 antibiotics, and 14% used ranitidine bismuth citrate (RBC) with 2 antibiotics. 45% of doctors also used furazolidone. 93% of doctors considered antibiotic resistance a serious problem. For rescue treatment 95% of doctors used quadruple therapy, or selected more effective drugs, increased the dosage of antibiotics and/or the duration of therapy. 83% of doctors evaluated the H. pylori status after a course of treatment. 52% of doctors learnt the knowledge about the management of H. pylori infection from 1999 Chinese Consensus. Conclusions: 1999 Chinese Consensus plays an important role in the management of H. pylori infection for the clinicians.