根除幽门螺旋杆共识.docVIP

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 negative association between the prevalenceof H pylori and the severity of GORD and incidence of esophageal adenocarcinoma.证据级别：2a流行病学证据表明幽门螺杆菌感染率与胃食管反流病严重程度及食管腺癌的发病率呈负相关。意见7. H pylori infection is associated with an increased risk ofuncomplicated and complicated gastroduodenal ulcers in NSAID and low-doseaspirin (acetosalicylic acid (ASA)) users. Eradication reduces the risk ofcomplicated and uncomplicated gastroduodenal ulcers associated with eitherNSAID or low-dose ASA use.证据级别：2a、1b使用非甾体类抗炎药及低剂量阿司匹林的患者发生伴或不伴并发症的胃十二指肠溃疡与幽