[韩国的幽门螺杆菌根除治疗]

[Helicobacter pylori eradication therapy in Korea].

作者信息

Kim Seung Young, Jung Sung Woo

机构信息

Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.

出版信息

Korean J Gastroenterol. 2011 Dec;58(2):67-73. doi: 10.4166/kjg.2011.58.2.67.

Abstract

Helicobacter pylori (H. pylori) is known to be associated with many gastrointestinal diseases including peptic ulcer. In Korea, eradication of H. pylori is recommended for peptic ulcer disease, low grade gastric mucosa-associated lymphoid tissue lymphoma, and early gastric cancer. Standard triple therapy using proton pump inhibitor, clarithromycin, and amoxicillin and bismuth-containing quadruple therapy have been the main first-line and second-line therapy for H. pylori in Korea. Although eradication rate of second-line quadruple therapy remains similar to that of the past, the success rate of eradication with triple therapy has decreased with increasing antimicrobial resistance to H. pylori. There is no standard third-line therapy, and some regimens that incorporate levofloxacin, moxifloxacin, and rifabutin can be used. New regimens such as sequential or concomitant therapy are suggested as alternative treatment for H. pylori. We need more well designed randomized controlled studies to choose proper treatment for H. pylori infection.

摘要

幽门螺杆菌(H. pylori)已知与包括消化性溃疡在内的多种胃肠道疾病相关。在韩国,对于消化性溃疡疾病、低级别胃黏膜相关淋巴组织淋巴瘤和早期胃癌,推荐根除幽门螺杆菌。使用质子泵抑制剂、克拉霉素、阿莫西林的标准三联疗法以及含铋剂的四联疗法一直是韩国幽门螺杆菌治疗的主要一线和二线疗法。尽管二线四联疗法的根除率仍与过去相似,但随着对幽门螺杆菌抗菌耐药性的增加,三联疗法的根除成功率有所下降。目前尚无标准的三线疗法,一些包含左氧氟沙星、莫西沙星和利福布汀的方案可供使用。序贯或伴同疗法等新方案被建议作为幽门螺杆菌的替代治疗方法。我们需要更多设计良好的随机对照研究来为幽门螺杆菌感染选择合适的治疗方法。

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