Kodama Masaaki, Murakami Kazunari, Okimoto Tadayoshi, Fujioka Toshio
Department of Gastroenterology, Faculty of Medicine, Oita University.
Nihon Rinsho. 2008 Apr;66(4):804-10.
The guidelines on the management of Helicobacter pylori were updated at the European Helicobacter study group third Maastricht consensus conference in March 2005. Especially, this conference emphasis on the management of non ulcer dyspepsia, GERD, and the patients who use non steroidal anti-inflammatory drug. Eradication of H. pylori is recommended in patients with peptic ulcer, low grade MALT lymphoma, atrophic gastritis, unexplained iron deficiency anemia, chronic idiopathic thrombocytopenic purpura and first degree relatives of patients with gastric cancer. H. pylori eradication is less effective than proton pomp inhibitor(PPI) treatment in preventing ulcer recurrence in long term NSAIDs users. This meeting also emphasized on the relationship between H. pylori and gastric cancer. The guideline concluded that H. pylori eradication has the potential to reduce the risk of gastric cancer development. Japanese guideline in 2003 does not mention the effect of eradication for prevention of gastric cancer. The H. pylori eradication and new strategy should be desirable for global strategy of gastric cancer prevention.
2005年3月，欧洲幽门螺杆菌研究小组第三次马斯特里赫特共识会议对幽门螺杆菌管理指南进行了更新。特别是，本次会议重点关注非溃疡性消化不良、胃食管反流病以及使用非甾体抗炎药的患者的管理。对于患有消化性溃疡、低度黏膜相关淋巴组织淋巴瘤、萎缩性胃炎、不明原因的缺铁性贫血、慢性特发性血小板减少性紫癜的患者以及胃癌患者的一级亲属，建议根除幽门螺杆菌。在长期使用非甾体抗炎药的患者中，根除幽门螺杆菌在预防溃疡复发方面的效果不如质子泵抑制剂（PPI）治疗。本次会议还强调了幽门螺杆菌与胃癌之间的关系。该指南得出结论，根除幽门螺杆菌有可能降低胃癌发生的风险。2003年的日本指南未提及根除幽门螺杆菌对预防胃癌的作用。对于全球胃癌预防策略而言，根除幽门螺杆菌及新策略是可取的。
