胃幽门螺杆菌感染诊疗进展

1982年,澳大利亚学者首先从人胃黏膜中培养出幽门螺杆菌（Helicobacterpylori,HP）,并确定它与胃十二指肠疾病的发病有关。有关HP感染的诊断和治疗取得了很大的进展。HP是一种呈螺旋状或S形、微需氧的革兰阴性杆菌,专一性定居于人胃,是人类慢性胃炎、消化性溃疡、胃癌和胃黏膜相关淋巴样组织（MALT）淋巴瘤的主要病因。HP在人群中的感染率非常高,而且一经感染,若不根除治疗,将终生携带,携带者是HP的传染源。HP感染的诊断方法分为两大类,侵入性和非侵入性。侵入性方法通过胃镜活检胃黏膜组织做细菌培养、组织病理学和快速尿素酶试验。非侵入性方法有血清学检查,13C、14C尿素呼气试验,聚合酶链反应（PCR）粪便HP抗原试验和尿液HP抗体试验等。HP相关疾病的治疗普遍采用2003年安徽桐城共识意见及2005年第4次全国HP学术会议上推荐的治疗方案。

Progress in Diagnosis and Treatment of Helicobacter Pylori Infection

In 1982, Australia scholars cultured helicobacter pylori （HP） from human gastric mucosa firstly, and confirmed the relationship between HP and gastroduodenal disease. The great progresses have been made in diagnosis and treatment of HP infection. HP is a kind of microaerobic gram-negative bacillil, which is helical or S-shaped, it settles down in human stomach, and is the main cause of chronic gastritis, peptic ulcer, gastric cancer and MALT lymphoma. HP infection rate in population is very high, and once a person is infected with HP without eradication therapy, he will become lifetime HP carrier. HP carriers are the source of infection. The diagnosis for HP infection includes invasive methods and non-invasive methods. The invasive methods are HP culture of endoscopic biopsy specimens of gastric mucosa, histopathological examination and rapid urease test. The non-invasive methods include serological examination, 13C or 14C urea breath test, PCR HPSA test and urine HP antibody test. 2003 Tongcheng consensus and therapeutic scheme recommended in 2005 fourth national HP conference are commonly adopted in treatment of HP related diseases.