Diaconu S, Predescu A, Moldoveanu A, Pop C S, Fierbințeanu-Braticevici C
Department of Internal Medicine II and Gastroenterology, University Emergency Hospital, Bucharest, Romania.
"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
J Med Life. 2017 Apr-Jun;10(2):112-117.
Helicobacter pylori is a spiral-shaped bacterium that grows in the digestive tract and may be present in more than half of the world's population. The clinical features of Helicobacter pylori range from asymptomatic gastritis to gastrointestinal malignancy. Mucosa-associated lymphoid tissue (MALT) lymphoma is a low-grade B-cell marginal zone lymphoma and Helicobacter pylori has been detected in more than 75% of the patients with MALT lymphoma. Many tests for the detection of Helicobacter pylori are available, including antibody tests, urea breath tests, stool antigen tests and endoscopic biopsies. The eradication of Helicobacter pylori usually prevents the return of ulcers and ulcer complications even after appropriate medications such as PPIs are stopped. The eradication of Helicobacter pylori is important in the treatment of the rare condition of the stomach known as MALT lymphoma. The treatment of Helicobacter pylori to prevent stomach cancer is controversial. Confirmation of eradication is recommended in associated ulcers, persistent dyspepsia despite a test-and-treat approach, MALT lymphoma, and previous treatment for early-stage gastric cancer. The urea breath test and stool antigen test can be used to confirm the eradication and should be performed at least 4 weeks after the completion of therapy. Several diseases have been reported to be associated with Helicobacter pylori infection, including hematologic diseases, such as ITP, idiopathic iron deficiency anemia and vitamin B12 deficiency. There is a positive trend in the association between Helicobacter pylori infection and neurodegenerative disorders and new data showed a reduced risk of death due to stroke and lung cancer but an increased risk of preeclampsia in infected women, which requires further investigations.
幽门螺杆菌是一种生长在消化道的螺旋形细菌,全球半数以上人口体内可能都有该细菌。幽门螺杆菌的临床特征范围广泛,从无症状性胃炎到胃肠道恶性肿瘤。黏膜相关淋巴组织(MALT)淋巴瘤是一种低度B细胞边缘区淋巴瘤,超过75%的MALT淋巴瘤患者体内检测到了幽门螺杆菌。检测幽门螺杆菌的方法有很多种,包括抗体检测、尿素呼气试验、粪便抗原检测和内镜活检。即使停用了质子泵抑制剂等适当药物,根除幽门螺杆菌通常也能防止溃疡复发及溃疡并发症。根除幽门螺杆菌在治疗罕见的胃部疾病MALT淋巴瘤方面很重要。幽门螺杆菌感染的治疗以预防胃癌存在争议。对于相关溃疡、尽管采用检测和治疗方法仍持续存在消化不良、MALT淋巴瘤以及早期胃癌的既往治疗情况,建议确认根除情况。尿素呼气试验和粪便抗原检测可用于确认根除情况,应在治疗完成后至少4周进行。据报道,几种疾病与幽门螺杆菌感染有关,包括血液系统疾病,如特发性血小板减少性紫癜、特发性缺铁性贫血和维生素B12缺乏症。幽门螺杆菌感染与神经退行性疾病之间的关联呈正向趋势,新数据显示,感染幽门螺杆菌的女性因中风和肺癌导致的死亡风险降低,但先兆子痫风险增加,这需要进一步研究。