Maev I V, Andreev D N, Kucheryavyi Yu A
A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia, Moscow, Russia.
Ter Arkh. 2015;87(8):103-110. doi: 10.17116/terarkh2015878103-110.
At present, the clinical significance of Helicobacter pylori infection has been validly determined within the development of a diversity of gastroduodenal diseases, including chronic gastritis, gastroduodenal ulcer, MALT lymphoma, and gastric adenocarcinoma. The Expert Council's Maastricht IV consensus (2010) determining international standards for the diagnosis and treatment of H. pylori infection is that there is evidence that the latter may be associated with the development of a number of extragastroduodenal diseases (EGDDs) presented by iron-deficiency anemia of unspecified etiology, idiopathic thrombocytopenic purpura, and vitamin B12 deficiency. In these diseases, it is recommended that infection with H. pylori be diagnosed and, if the test is positive, this microorganism be eradicated. A large number of investigations have been recently conducted to examine the association of H. pylori infection with other EGDDs. This paper reviews theoretical and epidemiological data on the association of H. pylori with diseases of the cardiovascular (atherosclerosis, myocardial infarction) and central nervous (Alzheimer's disease, Parkinson's disease) systems, pancreas (autoimmune pancreatitis, pancreatic cancer), oncological (colonic adenomas, colorectal cancer, hepatocellular carcinoma), dermatological (chronic spontaneous urticaria), and other EGDDs. The review highlights the potential protective role of H. pylori in diseases with the atopic element of genesis and a complicated course of gastroesophageal reflux disease (Barrett's esophagus, esophageal adenocarcinoma).
目前,幽门螺杆菌感染的临床意义已在多种胃十二指肠疾病的发展过程中得到有效确定,这些疾病包括慢性胃炎、胃十二指肠溃疡、黏膜相关淋巴组织淋巴瘤和胃腺癌。专家委员会的《马斯特里赫特IV共识》(2010年)确定了幽门螺杆菌感染的国际诊断和治疗标准,即有证据表明后者可能与一些胃外十二指肠疾病(EGDDs)的发生有关,这些疾病包括病因不明的缺铁性贫血、特发性血小板减少性紫癜和维生素B12缺乏症。在这些疾病中,建议对幽门螺杆菌感染进行诊断,如果检测呈阳性,则根除这种微生物。最近进行了大量调查,以研究幽门螺杆菌感染与其他胃外十二指肠疾病的关联。本文综述了关于幽门螺杆菌与心血管系统疾病(动脉粥样硬化、心肌梗死)、中枢神经系统疾病(阿尔茨海默病、帕金森病)、胰腺疾病(自身免疫性胰腺炎、胰腺癌)、肿瘤疾病(结肠腺瘤、结直肠癌、肝细胞癌)、皮肤病(慢性自发性荨麻疹)以及其他胃外十二指肠疾病关联的理论和流行病学数据。该综述强调了幽门螺杆菌在具有特应性发病因素的疾病以及胃食管反流病复杂病程(巴雷特食管、食管腺癌)中的潜在保护作用。