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首页> 外文期刊>Chinese journal of digestive diseases >Should we eradicate Helicobacter pylori infection in patients receiving nonsteroidal anti-inflammatory drugs or low-dose aspirin?
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Should we eradicate Helicobacter pylori infection in patients receiving nonsteroidal anti-inflammatory drugs or low-dose aspirin?

机译：在接受非甾体抗炎药或小剂量阿司匹林的患者中，我们应该根除幽门螺杆菌感染吗？

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摘要

Whether Helicobacter pylori infection alters the risk of ulcer disease in patients receiving nonsteroidal anti-inflammatory drugs (NSAIDs) or low-dose aspirin is one of the most controversial topics in peptic ulcer research. This is an important management issue, particularly in countries where peptic ulcer disease is common and the prevalence of H. pylori infection is high. Current evidence shows that H. pylori infection increases the ulcer risk associated with NSAIDs or low-dose aspirin. Eradication of H. pylori reduces the subsequent risk of endoscopic and complicated ulcers in patients who are about to start long-term NSAIDs. Among patients with H. pylori infection and a history of ulcer bleeding who continue to use low-dose aspirin, 1 week of eradication therapy prevents recurrent ulcer bleeding. Failure of eradication and concomitant use of NSAIDs, however, account for most cases of recurrent bleeding with low-dose aspirin. The apparent protective effect of H. pylori in long-term NSAIDs users reported in some studies was actually the weeding out of susceptible patients who were intolerant to NSAIDs. There is no convincing evidence that eradication of H. pylori has any clinically important adverse effect on the healing and prevention of ulcers in NSAIDs users.
机译：幽门螺杆菌感染是否会改变接受非甾体抗炎药（NSAID）或低剂量阿司匹林的患者患溃疡病的风险，是消化性溃疡研究中最有争议的话题之一。这是一个重要的管理问题，尤其是在消化性溃疡病很常见且幽门螺杆菌感染率很高的国家。当前证据表明幽门螺杆菌感染会增加与NSAIDs或小剂量阿司匹林有关的溃疡风险。根除幽门螺杆菌可降低即将开始长期NSAID的患者发生内镜和复杂溃疡的风险。在持续使用低剂量阿司匹林的幽门螺杆菌感染和溃疡出血史患者中，根除治疗1周可预防溃疡复发。然而，根除失败和同时使用非甾体抗炎药是低剂量阿司匹林复发性出血的大多数病例。在一些研究中，幽门螺杆菌对长期使用非甾体抗炎药的用户具有明显的保护作用，实际上是清除了对非甾体抗炎药不耐受的易感患者。没有令人信服的证据表明，根除幽门螺杆菌对NSAIDs使用者的溃疡愈合和预防具有任何临床上重要的不利影响。

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