根除幽门螺旋杆菌共识

第一部分什么样的病人需要接受除菌治疗？ 意见1. A test-and-treat strategy is appropriate for uninvestigateddyspepsia in popul ations where the H pylori prevalence is high ($ 20%). Thisapproach is subject to loc al cost e benefit considerations and is notapplicable to patient s with alarm symptoms , or older patients (age to bedetermined locally according to cancer risk) 证据级别：1a 幽门螺杆菌高感染率地区（感染率≥20%）的消化不良患者，可选用“检查-治疗“方案，即选择非侵入性检查检测幽门螺杆菌，并对阳性患者进行杀菌治疗。是否选择“检查-治疗”方案取决于当地的费效比，具报警症状及高龄（高龄的界定取决于当地肿瘤风险）患者不适用“检查-治疗”方案。 意见2. Statement 2: The main non-invasive tests that can be used for thetest-and-treat strategy are the UBT and monoclonal stool antigen tests. Certainvalidated serological tests can also be used. 证据级别：2a 主流的非侵入性幽门螺杆菌检查方法包括UBT 检测、大便抗原单克隆抗体检测及部分被证明可信度高的血清学检查。 意见3. H pylori eradication produces long-term relief of dyspepsia inone of 12 patients with H pylori and functional dyspepsia; this is better thanany other treatment. 证据级别：1a 根除幽门螺杆菌可使 1/12 的幽门螺杆菌阳性的功能性消化不良患者症状得到长期缓解，效果优于其他任何治疗方法。 意见4. H pylori can increase or decrease acid secretion depending on theintragastric distributio n of inflammation. 证据级别：2b 幽门螺杆菌抑制或增加胃酸分泌取决于胃内炎症的分布。 意见5. On average, H pylori status has no effect on symptom severity,symptom recurrence and treatment efficacy in GORD. H pylori eradication doesnot exacerbate pre-existing GORD or affect treatment efficacy. 证据级别：1a 整体来说，幽门螺杆菌与胃食管反流疾病的症状严重程度、复发及疗效无显著关联。根除幽门螺杆菌不会加重既有胃食管反流疾病症状，也不会影响其疗效。 意见6. Epidemiological studies show a negati...