Louw J A, Marks I N
Gastrointestinal Clinic, Groote Schuur Hospital, Observatory, Cape Town, South Africa.
Yale J Biol Med. 1998 Mar-Apr;71(2):113-7.
Helicobacter pylori is now considered a major pathogen of the upper gastrointestinal tract. It is seen as an important cause of peptic ulceration not associated with NSAID use. It is also increasingly linked to other diseases of the GI tract, although the relationship between the organism and conditions such as gastric cancer, non-ulcer dyspepsia and gastroesophageal reflux disease is not as clear as is the case in peptic ulcer disease. This is probably because of a lack of well-performed, statistically powerful, prospective therapeutic trials that indicate that H. pylori eradication is of benefit in these diseases. The high infection rate without overt disease seen in many populations, especially from developing countries, probably contributes to this "credibility gap." While we have excellent therapeutic regimens available at this time, rational targeting requires that the objective evidence in favor of therapeutic intervention in upper GI disease, as well as the local H. pylori epidemiology, needs to be considered.
幽门螺杆菌现在被认为是上消化道的主要病原体。它被视为与非甾体抗炎药使用无关的消化性溃疡的重要病因。它也越来越多地与胃肠道的其他疾病相关联，尽管该生物体与诸如胃癌、非溃疡性消化不良和胃食管反流病等病症之间的关系并不像消化性溃疡病那样明确。这可能是因为缺乏执行良好、具有统计学效力的前瞻性治疗试验，这些试验表明根除幽门螺杆菌对这些疾病有益。在许多人群中，尤其是来自发展中国家的人群中，高感染率但无明显疾病的情况可能导致了这种“可信度差距”。虽然我们目前有出色的治疗方案，但合理的靶向治疗需要考虑支持上消化道疾病治疗干预的客观证据以及当地的幽门螺杆菌流行病学情况。
