Hunt R H, Huang J Q
Division of Gastroenterology, McMaster University Medical Center, Hamilton, Ontario, Canada.
Eur J Surg Suppl. 1998(582):6-10. doi: 10.1080/11024159850191373.
H. pylori is probably the commonest bacterial infection worldwide and associated with a number of clinical outcomes including chronic active gastritis, peptic ulcer, gastric adenocarcinoma, gastric MALT lymphoma and possibly dyspepsia. Treatment to eradicate H. pylori infection has changed significantly the natural history of peptic ulcer disease and is now the recommended approach to patients with non-NSAID gastric and duodenal ulcers. Controversies remain as to whether H. pylori infection is a cause of dyspepsia and non-ulcer dyspepsia. However, results from several economic models evaluating a "test and treat" strategy have suggested that eradication of H. pylori infection as an initial choice is the most cost-effective approach and has a long-term benefit in a significant proportion of patients with dyspepsia. The conclusion of H. pylori as a group 1 human carcinogen by the IARC and the subsequent analyses have added further to the recommendation for eradication of the infection.
幽门螺杆菌可能是全球最常见的细菌感染，与多种临床结局相关，包括慢性活动性胃炎、消化性溃疡、胃腺癌、胃黏膜相关淋巴组织淋巴瘤以及可能的消化不良。根除幽门螺杆菌感染的治疗显著改变了消化性溃疡疾病的自然病程，目前是治疗非非甾体抗炎药相关性胃和十二指肠溃疡患者的推荐方法。关于幽门螺杆菌感染是否是消化不良和非溃疡性消化不良的病因仍存在争议。然而，几个评估“检测和治疗”策略的经济模型结果表明，将根除幽门螺杆菌感染作为初始选择是最具成本效益的方法，并且对相当一部分消化不良患者有长期益处。国际癌症研究机构将幽门螺杆菌列为1类人类致癌物，随后的分析进一步增加了根除该感染的推荐依据。
