幽门螺杆菌根除方案和影响因素

随着抗菌药物耐药性的不断上升，经典三联疗法对幽门螺杆菌（Hp）的根除率明显降低。近年出现的新治疗策略可替代三联疗法作为一线疗法，包括序贯疗法、含铋剂的四联疗法、伴同疗法、混合疗法等，以左氧氟沙星、利福布丁和呋喃唑酮为基础的疗法可作为补救治疗。此外，中药和益生菌亦可作为补充治疗。考虑到Hp的耐药性、CYP2C19基因表型、吸烟等诸多因素对根除效果的影响，临床医师应根据具体情况选择合理的治疗方案。本文就近年Hp根除治疗方案和影响因素作一综述。

Regimens and Influencing Factors of Helicobacter pylori Eradication

With the increase of antibiotic resistance, Helicobacter pylori （Hp） eradication rate of traditional triple therapy is decreasing. Several new treatment strategies including sequential therapy, bismuth-containing quadruple therapy, concomitant therapy and hybrid therapy could be served as alternative first-line therapies. Levofloxacin-based therapy, rifabutin-based therapy and furazolidone-based therapy might be employed as rescue treatment. Chinese herbal medicine and probiotics could also be used as complementary therapies. Clinicians should take factors such as antibiotics resistance, CYP2C19 genotype and smoking into account, which could influence the efficacy when choosing eradication regimens. This article reviewed therapies and influencing factors of Hp eradication in recent years.