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| 1 | 成都地区居民幽门螺杆菌感染现状及危险因素分析显示文摘目的了解成都地区居民幽门螺杆菌(Helicobacter pylori,Hp)的感染情况及其危险因素。方法对来我院做健康体检的成都地区居民行血清Hp-IgG抗体检测,同时测量研究对象身高、体重、腰围、血压,并记录生活习惯情况。采用多因素logistic回归分析Hp感染相关危险因素。结果共计纳入47035例成都居民,人群Hp总阳性率为37.2%,其中男、女性Hp阳性率分别为37.9%、36.4%,男女差异有统计学意义(χ^2=10.55,P=0.001)。随着BMI的增加,Hp阳性率逐渐升高(χ^2=62.42,P<0.001)。年龄小于70岁体检者的Hp阳性率随着年龄的增加而增加(χ^2=248.06,P<0.001)。少数民族、吸烟、饮酒体检者的Hp阳性率高于汉族、非吸烟、不饮酒体检者(P值均<0.05)。多因素非条件logistic回归分析显示:年龄增大(OR=1.68,95%CI:1.56~1.81)、BMI≥24(OR=1.27,95%CI:1.11~1.45)或腹型肥胖(OR=1.07,95%CI:1.02~1.12)、少数民族(OR=1.50,95%CI:1.37~1.64)是Hp感染的危险因素;运动(OR=1.62,95%CI:0.41~0.94)是保护因素,可以减少Hp的感染。结论成都地区居民Hp感染率低于全国平均水平,但仍较为流行。应加强Hp感染相关知识的宣传教育和科普,减少易感因素,培养运动习惯,控制体重指数,减少Hp感染风险。 | 杨玉梅 刘玉萍 王林 李东宇 帅平 | 2020 | 现代预防医学2020，47，17： | 18 |
| 2 | 亚洲人群中序贯疗法与三联疗法根除幽门螺旋杆菌临床疗效的Meta分析显示文摘目的 评价在亚洲人群中序贯疗法与三联疗法根除幽门螺旋杆菌(Helicobacter pylori,H.pylori)临床疗效的差异.方法 计算机检索中文数据库和外文数据库包括万方数据库、中国知网、维普数据库、中国生物医学文献数据库(CBM)、Medline/Pubmed、Embase、Wiley、Springer和Elsevier;手工检索《中华消化杂志》、《世界华人消化杂志》和会议记录.查找与此研究相关的临床随机对照试验(RCT)文献,采用Cochrane系统评价员手册5.0.2版推荐的方法纳入文献,并对其进行Meta分析.结果 共纳入19篇临床随机对照(RCT)文献,纳入患者2 854例,其中采用序贯疗法的患者1 282例,采用三联疗法的患者1 572例.对19篇RCT研究进行Meta分析的结果显示:序贯疗法根除幽门螺旋杆菌(H.pylori)的疗效优于三联疗法,差异具有统计学意义(P<0.05).序贯疗法和三联疗法根除率的意向处理(ITT)分析分别为86.91%和73.47% (OR=2.43,95% CI:1.83 ~ 3.22,P<0.05),序贯疗法与三联疗法根除率的试验方案(PP)分析分别为89.85%和77.32%(OR=2.51,95%CI:1.91~3.30,P<0.05).对于溃疡显效情况、疼痛缓解情况和不良反应发生情况等,由于条件所限未能进行Meta分析,仅进行了描述性分析.结论 在亚洲人群中,序贯疗法较传统三联疗法具有较高的H.pylori根除率,为当前由于H.pylori抗生素耐药性提高而引起的三联疗法治疗成功率降低提供了一种新的选择,在临床上具有很好的应用前景.但目前相关RCT研究样本量少,且普遍质量较低.上述结论尚需要高质量、多中心、大样本量的随机双盲试验加以证实. | 林梦娟 余保平 | 2014 | 胃肠病学和肝病学杂志2014，23，7： | 17 |
| 3 | 以雷贝拉唑为基础的不同疗程三联疗法治疗幽门螺杆菌感染疗效的Meta分析显示文摘目的对以雷贝拉唑为基础的三联疗法根治幽门螺杆菌(H.pylori)感染7、10、14d疗效进行Meta分析,以客观评价其疗效。方法计算机检索维普数据库、万方数据库、中国知网数据库(CNKI)、PubMed数据库,查找以雷贝拉唑为基础的不同疗程三联疗法治疗H.pylori感染的相关文献,运用Review Manager5.2软件对文献数据进行分析。结果以雷贝拉唑为基础的三联疗法在H.pylori根除率方面,10d和14d疗程效果优于7d疗程,差异具有统计学意义(7dvs.10dOR=0.72,95%CI:0.53-0.96,P=0.030;7dvs.14dOR=0.49,95%CI:0.31-0.79,P=0.003),但10d和14d疗程差异无统计学意义(OR=0.79,95%CI:0.47-1.34,P=0.390);在不良反应发生率方面,7、10、14d3个疗程分别两两组间对比,差异均无统计学意义(7d vs.10dOR=1.05,95%CI:0.75-1.47,P=0.780;7dvs.14dOR=0.80,95%CI:0.32-2.00,P=0.630;10dvs.14dOR=0.82,95%CI:0.45-1.50,P=0.530);在临床症状缓解率方面,上述各组间对比亦无统计学证据支持何种疗程更加有效(7dvs.10d;OR=0.79,95%CI:0.31-2.04,P=0.630;7dvs.14d:OR=0.72,95%CI:0.26-2.00,P=0.530;10dvs.14d:OR=0.92,95%CI:0.32-2.63,P=0.870)。结论在以雷贝拉唑为基础的三联疗法治疗H.pylori感染时,结合患者经济负担及依从性考虑,建议用药10d则可达到治疗目的。 | 童婷婷 姜政 刘畅 曹国栋 胡丹 | 2016 | 重庆医学2016，45，15： | 13 |
| 4 | 健康体检人员血清幽门螺杆菌尿素酶抗体的流行病学调查显示文摘目的分析无锡地区健康体检人员血清幽门螺杆菌尿素酶抗体的资料,以探讨近年无锡地区人员幽门螺杆菌感染的流行情况,更好地把握消化道疾病的病因变化和改进预防治疗策略。方法调查2009年1月-2012年12月来医院参加健康体检人员共35 921人,使用免疫胶体金法对其进行血清幽门螺杆菌尿素酶抗体检测,数据采用PEMS3.1软件进行统计处理。结果参加健康体检35 921人员中有15 490人血清幽门螺杆菌尿素酶抗体阳性,阳性率为43.12%;2010年检测阳性率最高为50.70%,2011和2012年阳性率逐年下降,分别为42.12%和35.99%,各年份间比较,差异有统计学意义(P〈0.05),男女性别之间阳性率比较,差异无统计学意义;年龄41-60岁人员检测阳性率最高为45.31%,各年龄间比较,差异有统计学意义(P〈0.05)。结论无锡地区人员普遍易感幽门螺杆菌,定期检测血清幽门螺杆菌尿素酶抗体对及早发现幽门螺杆菌感染有重要意义。 | 周颖 马坚 胡志刚 | 2014 | 中华医院感染学杂志2014，24，23： | 8 |
| 5 | Optimizing clarithromycin-containing therapy for Helicobacter pylori in the era of antibiotic resistance显示文摘The efficacy of triple therapy for Helicobacter pylori infection has dramatically declined over the last decade,largely related to increasing clarithromycin resistance rates.From a microbiological standpoint,bismuth quadruple therapy is the ideal replacement since it combines drugs for which resistance does not impair its efficacy.Nonetheless,several obstacles such as availability,complexity or tolerance prevent a general implementation of bismuth quadruple therapy,so nonbismuth quadruple regimens remain the best firstline treatment in clinical practice in many geographical areas.We review the rationale and efficacy of several optimization tools(increasing the length of duration,high-dose acid suppression,probiotics),which have been largely evaluated over the last 5 years to increase the effectiveness of standard triple therapy.Then,we update available evidence on the effectiveness of several non-bismuth quadruple therapies(sequential,concomitant,hybrid,miscellaneous therapy),which have gained interest lately.We also revise evidence on the efficacy of the aforementioned optimization tools for non-bismuth quadruples schemes and,finally we provide a novel regionalized therapeutic algorithm,based on novel formulas recently developed for predicting the outcome of non-bismuth quadruple regimens,upon local antibiotic resistance rates. | Javier Molina-Infante Javier P Gisbert | 2014 | World Journal of Gastroenterology2014，20，30： | 7 |
| 6 | 序贯疗法根除幽门螺杆菌感染显示文摘序贯疗法是目前欧洲MaastrichtⅣ共识意见中推荐的幽门螺杆菌(Hp)感染的一线经验性根除方案之一,其根除率、耐受性及安全性均较令人满意,但国内缺乏相关研究及应用经验。此文对目前国际上应用序贯疗法根除Hp感染的相关研究作一综述。 | 张慧 宋志强 周丽雅 | 2015 | 国际消化病杂志2015，35，1： | 4 |
| 7 | Management of Helicobacter pylori infection in Latin America: A Delphi technique-based consensus显示文摘AIM: To optimize diagnosis and treatment guidelines for this geographic region, a panel of gastroenterologists, epidemiologists, and basic scientists carried out a structured evaluation of available literature.METHODS: Relevant questions were distributed among the experts, who generated draft statements for consideration by the entire panel. A modified three-round Delphi technique method was used to reach consensus. Critical input was also obtained from representatives of the concerned medical community. The quality of the evidence and level of recommendation supporting each statement was graded according to United States Preventive Services Task Force criteria.RESULTS: A group of ten experts was established. The survey included 15 open-ended questions that were distributed among the experts, who assessed the articles associated with each question. The levels of agreement achieved by the panel were 50% in the first round, 73.3% in the second round and 100% in the third round. Main consensus recommendations included:(1) when available, urea breath and stool antigen test(HpSA) should be used for non-invasive diagnosis;(2) detect and eradicate Helicobacter pylori(H. pylori) in all gastroscopy patients to decrease risk of peptic ulcer disease, prevent o retard progression in patients with preneoplastic lesions, and to prevent recurrence in patients treated for gastric cancer;(3) further investigate implementation issues and health outcomes of H. pylorieradication for primary prevention of gastric cancer in high-risk populations;(4) prescribe standard 14-d triple therapy or sequential therapy for first-line treatment;(5) routinely assess eradication success post-treatment in clinical settings; and(6) select second- and third-line therapies according to antibiotic susceptibility testing.CONCLUSION: These achievable steps toward better region-specific management can be expected to improve clinical health outcomes. | Antonio Rollan Juan Pablo Arab M Constanza Camargo Roberto Candia Paul Harris Catterina Ferreccio Charles S Rabkin Juan Cristóbal Gana Pablo Cortés Rolando Herrero Luisa Durán Apolinaria García Claudio Toledo Alberto Espino Nicole Lustig Alberto Sarfatis Catalina Figueroa Javier Torres Arnoldo Riquelme | 2014 | World Journal of Gastroenterology2014，20，31： | 2 |
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