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首页> 美国卫生研究院文献>Therapeutic Advances in Gastroenterology >Eradication of Helicobacter Pylori to Prevent Gastroduodenal Diseases: Hitting more than One Bird with the Same Stone
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Eradication of Helicobacter Pylori to Prevent Gastroduodenal Diseases: Hitting more than One Bird with the Same Stone

机译：根除幽门螺杆菌以预防胃十二指肠 疾病：用同一块石头击中不止一只鸟

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Helicobacter pylori (H. pylori) are gram-negative bacteria that selectively colonizes the gastric mucosa. The prevalence of H. pylori infection varies from 20 to 50% in industrialized countries to over 80% in developing countries. The infection may persist lifelong without specific treatment. Prolonged infection and inflammation due to bacterial virulence and host genetic factors will lead to chronic gastritis. A certain portion of infected patients then develop more severe pathologies such as peptic ulcer (10–15%), gastric cancer (1%), and mucosa-associated lymphoid tissue lymphoma (50.01%). Although the majority of infected patients remain asymptomatic, much of the evidence has shown that eradication of H. pylori infection can reduce the recurrence of peptic ulcer and benefit a substantial portion of patients with nonulcer dyspepsia. Though controversial in population-based clinical trials, several cost-effectiveness analyses also reveal that H. pylori eradication is cost effective in the primary prevention of gastric cancer. Therefore, the discovery of H. pylori offers the chance to prevent several gastroduodenal diseases by means of their eradication. In other words, gastroenterologists could hit more than one bird with one stone. However, there are concerns regarding application of a ‘test and treat’ strategy in the general population. In this review, we will focus on current evidence of H. pylori eradication in the primary and secondary prophylaxis of gastric cancer and peptic ulcer disease.
机译：幽门螺杆菌（H. pylori）是革兰氏阴性细菌，可选择性地定居在胃粘膜上。幽门螺杆菌感染的流行率从工业化国家的20％到50％到发展中国家的80％以上不等。如果没有特殊治疗，感染可能会持续一生。由于细菌毒性和宿主遗传因素引起的长期感染和炎症将导致慢性胃炎。然后，一定比例的感染患者会出现更严重的病状，例如消化性溃疡（10％至15％），胃癌（1％）和与黏膜相关的淋巴样组织淋巴瘤（50.01％）。尽管大多数被感染的患者保持无症状，但是许多证据表明，根除幽门螺杆菌感染可以减少消化性溃疡的复发，并使非溃疡性消化不良的患者受益。尽管在基于人群的临床试验中存在争议，但一些成本效益分析还显示，根除幽门螺杆菌在胃癌的一级预防中具有成本效益。因此，幽门螺杆菌的发现提供了通过根除其预防几种胃十二指肠疾病的机会。换一种说法， 肠胃病学家可能用一块石头击中不止一只鸟。但是，那里 对“测试和治疗”的应用感到担忧 一般人群中的策略。在这篇评论中，我们将重点关注当前 在原发性和继发性幽门螺杆菌根除的证据 预防胃癌和消化性溃疡疾病。

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