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抗幽门螺杆菌治疗的争议。

The controversy over anti-Helicobacter pylori therapy.

机构信息

Department of Bacterial Genetics, Institute of Microbiology, Faculty of Biology, University of Warsaw, Warsaw, Poland.

出版信息

Pol J Microbiol. 2012;61(4):239-46.

Abstract

Helicobacter pylori is a Gram-negative spiral-shaped bacterium, member of epsilon-Proteobacteria specifically colonizing the gastric epithelium of humans. It causes one of the most common infections worldwide, affecting about half of the world's population. However, it should be noted that the prevalence of H. pylori, particularly in the Western world, has significantly decreased coinciding with an increase of some autoimmune and allergic diseases, such as asthma. Various epidemiological studies have also documented a negative association between H. pylori colonization and the presence of GERD (gastroesophageal reflux disease) and risk of esophageal cancer. Additionally, an upward trend of obesity recently observed in inhabitants of developed countries raised a question about the relationship between H. pylori infection and the human body mass index. The first part of this review describes common, recommended anti-H. pylori treatments. The second part, presents the results of recent experiments aimed at evaluating the association between H. pylori infections and gastro-esophageal diseases, the level of stomach hormones, the human body mass index and allergic diseases. Although some studies suggest an inverse association of H. pylori infection with some health problems of the modern world such as asthma, obesity or GERD, H. pylori should be considered as a harmful human pathogen responsible for serious and sometimes lethal diseases. Thus, many scientists advocate the eradication of H. pylori.

摘要

幽门螺杆菌是一种革兰氏阴性螺旋形细菌,属于ε-变形菌纲,专门定植于人类的胃上皮细胞。它是全球最常见的感染之一,影响了约一半的世界人口。然而,应当指出的是,幽门螺杆菌的流行率,特别是在西方世界,随着一些自身免疫和过敏性疾病(如哮喘)的增加而显著下降。各种流行病学研究还记录了幽门螺杆菌定植与 GERD(胃食管反流病)的存在和食管癌风险之间的负相关。此外,最近在发达国家居民中观察到的肥胖率上升,引发了关于幽门螺杆菌感染与人体体重指数之间关系的问题。本文第一部分描述了常见的、推荐的抗幽门螺杆菌治疗方法。第二部分介绍了最近旨在评估幽门螺杆菌感染与胃食管疾病、胃激素水平、人体体重指数和过敏性疾病之间关联的实验结果。尽管一些研究表明,幽门螺杆菌感染与哮喘、肥胖或 GERD 等现代世界的一些健康问题呈负相关,但幽门螺杆菌仍应被视为一种有害的人类病原体,可导致严重甚至致命的疾病。因此,许多科学家主张根除幽门螺杆菌。

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