Tytgat G N
Department of Gastroenterology, Academic Medical Center, Amsterdam, The Netherlands.
Aliment Pharmacol Ther. 2000 Oct;14 Suppl 3:55-8. doi: 10.1046/j.1365-2036.2000.03101.x.
This paper contains a personal view on what has been achieved in Helicobacter pylori research and what the expectations might be for further developments. Knowledge about the organism is already extensive. Particularly intriguing are the differences in genetic make-up in the various geographical regions. Sadly, detailed knowledge on how the organism spreads is still lacking. The clinical spectrum of the disease in man is largely known, but as H. pylori is disappearing worldwide, the relative frequency of H. pylori-negative ulcer disease is increasing. To what extent H. pylori disappearance and eradication is responsible for the decreasing incidence of gastric cancer remains uncertain. Antimicrobial therapy is dominated by proton pump inhibitor triple therapy as first line with quadruple therapy as second-line therapy. The long-term consequences of the rising resistance to the 'key' antimicrobials are so far unknown and speculative.
本文就幽门螺杆菌研究已取得的成果以及对未来进一步发展的期望提出了个人观点。关于这种微生物的知识已经很广泛。特别有趣的是不同地理区域基因构成的差异。遗憾的是，关于该微生物如何传播的详细知识仍然缺乏。人类疾病的临床谱在很大程度上是已知的，但由于幽门螺杆菌在全球范围内正在消失，幽门螺杆菌阴性溃疡病的相对发生率正在增加。幽门螺杆菌的消失和根除在多大程度上导致了胃癌发病率的下降仍不确定。抗菌治疗以质子泵抑制剂三联疗法作为一线治疗，四联疗法作为二线治疗为主。对“关键”抗菌药物耐药性上升的长期后果目前尚不清楚且只是推测。
