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| 1 | 日本幽门螺杆菌感染管理指南(2016修订版)解读显示文摘背景2009年日本幽门螺杆菌研究学会(JSHR)指南将“幽门螺杆菌感染”定为适应证,因此自2013年起日本将幽门螺杆菌性胃炎根除治疗纳入医疗保险,根除幽门螺杆菌病例数量迅速增加。在这种情况下,JSHR7年来首次对《幽门螺杆菌感染诊断和治疗指南》进行了第三次修订。方法通过JSHR指导委员会举行的10次会议,将2009年指南制定开始至2016年3月发表的文章根据证据级别进行了审查和分类;在本次审查的基础上对声明进行了修订。在征求公众意见后,采用德尔菲法最终确定了修订后的指南。结果幽门螺杆菌感染属于感染性疾病,根除幽门螺杆菌的基本方针未改变。其他被认为与幽门螺杆菌感染有关的疾病被作为适应证添加。增加了血清胃蛋白酶原水平、内镜检查、X射线检查等诊断方法。由钾竞争性酸阻滞剂(P-CAB)、阿莫西林和克拉霉素组成的1周三联疗法的效果有所改善,质子泵抑制剂(PPI)或P-CAB联合阿莫西林和甲硝唑也期望有较高的根除率。如果不进行敏感性试验,则应选择三联PPI或P-CAB/阿莫西林/甲硝唑治疗,因为PPI/阿莫西林/甲硝唑联合治疗的根除率明显高于PPI/阿莫西林/克拉霉素。在胃癌预防方案中,我们按年龄从青少年到老年提供了胃癌预防措施,这些年龄段的人群胃癌风险增加,并提出了基于根除幽门螺杆菌的胃癌预防措施。结论我们期望修订后的指南能够为幽门螺杆菌感染患者提供适当的干预措施,并完成根除和预防胃癌的工作。 | 王芬 | 2019 | 胃肠病学和肝病学杂志2019，28，10： | 28 |
| 2 | 幽门螺杆菌粪便检测法在上消化道出血患者中的应用价值显示文摘目的:探讨粪便幽门螺杆菌抗原(Helicobacter pylori stool antigen,HpSA)检测方法在上消化道出血患者中的临床应用价值。方法:选择2015年4月至2016年5月在蚌埠医学院附属泰兴市人民医院就诊的因消化道症状接受胃镜检查的101例患者,对其进行胃黏膜快速尿素酶法(rapid urea testse,RUT)、粪便HpSA及胃黏膜幽门螺杆菌(Hp)PCR检测。以RUT检测结果为诊断Hp感染的'金标准',将HpSA、PCR检测结果与其进行对比分析。结果:以RUT作为Hp感染的诊断金标准,HpSA检测的敏感度为86.67%(52/60)、特异度为95.12%(39/41)、阳性预测值为96.30%(52/54)、阴性预测值为82.98%(39/47)、准确度为90.10%(91/101);PCR检测的敏感度为80.00%(48/60)、特异度为97.56%(40/41)、阳性预测值为97.96%(48/49)、阴性预测值为76.92%(40/52)、准确度为87.13%(88/101)。HpSA检测与RUT一致性比较,Kappa=0.80;PCR与RUT一致性比较,Kappa=0.74。结论:HpSA检测方法与金标准具有较高的一致性,上消化道出血时检测结果可靠,是非侵入性诊断Hp感染的可靠方法。 | 孙娟 成宏伟 | 2017 | 中国临床医学2017，24，1： | 12 |
| 3 | Stool antigen tests for the management of Helicobacter pylori infection显示文摘Stool antigen tests(SATs)are noninvasive diagnostic modules for Helicobacter pylori(H.pylori)infection.Two types of SATs exist for the diagnosis of H.pylori infection,one based on enzyme immunoassay(EIA)and another on immunochromatography(ICA).SATs do not require expensive chemical agents or specified equipment;hence,they are less expensive compared with the urea breath test.Both European and Japanese guidelines have shown that EIA-based SATs using monoclonal antibodies are useful for primary diagnosis as well as for the assessment of eradication therapy.ICA-based tests do not require particular equipment and are therefore useful in developing countries.SATs are also useful for the diagnosis of H.pylori infection in children and post gastric surgery patients.SATs performed via EIA can assess H.pylori infection in a large number of subjects,almost as well as serology.Thus,SATs would be useful or detecting current infection in such a survey to identify and eradicate H.pylori infection.The accuracy of SATs is lower when the stool samples are unformed or watery,because H.pylorispecific antigens in the stool samples are diluted.Temperature and the interval between stool sample collection and measurement also affect the results of SATs.The choice of test kit depends on the sensitivity and specificity in each region and the circumstances of each patient. | Tadashi Shimoyama | 2013 | World Journal of Gastroenterology2013，19，45： | 8 |
| 4 | 幽和汤与雷贝拉唑钠肠溶片治疗Hp感染疗效观察及对比研究显示文摘目的:观察幽和汤及雷贝拉唑钠肠溶片治疗幽门螺杆菌(Hp)感染的疗效,并进行对比分析,探讨中医、西医治疗HP感染的有效性以及幽和汤是否具备替代抗生素治疗Hp感染的可行性。方法:选取2014年10月~2015年10月陕西中医药大学附属医院收治的87例患者为研究对象,随机均分为3组,分别为治疗组1、治疗组2和对照组。治疗组1:口服幽和汤,每日1剂,分2次服用,每次100ml;治疗组2:口服雷贝拉唑钠肠溶片(10mg/片),每日2次,一次1片。对照组:口服雷贝拉唑钠肠溶片(10mg/片),每日2次,一次1片;盐酸左氧氟沙星片(0.1g/片),每日2次,一次2片;克拉霉素片(0.25g/片),每日2次,一次2片;以上药物疗程均为15天。对比分析3组之间的临床疗效、HP感染根除率。结果:幽和汤治疗组1、雷贝拉唑钠肠溶片治疗组2及三联疗法对照组的Hp根除率分别为31.03%、34.48%、65.52%,幽和汤治疗组1、雷贝拉唑钠肠溶片治疗组2与三联疗法对照组比较,差异均有统计学意义(P〈0.05)。治疗前,幽和汤治疗组1、雷贝拉唑钠肠溶片治疗组2及三联疗法对照组三组间症状总积分比较,差异无统计学意义(P〉0.05),具有可比性;治疗后幽和汤治疗组1、雷贝拉唑钠肠溶片治疗组2及三联疗法对照组症状总积分均优于治疗前,差异有统计学意义(P〈0.05),且幽和汤治疗组1、雷贝拉唑钠肠溶片治疗组2优于三联疗法对照组,组间比较差异有统计学意义(P〈0.05)。治疗后幽和汤治疗组1、雷贝拉唑钠肠溶片治疗组2及三联疗法对照组总有效率分别为89.66%、93.10%、62.07%,幽和汤治疗组1、雷贝拉唑钠肠溶片治疗组2总有效率均优于三联疗法对照组,组间比较差异有统计学意义(P〈0.05)。结论:治疗组1、治疗组2的Hp根除率均低于对照组;治疗组1、治疗组2总有效率均优于对照组;治疗组1与治疗组2比较无显著差异;幽和汤不具备替代抗生素治疗Hp感染的可行性。 | 周晓燕 王鹏利 | 2016 | 四川中医2016，34，10： | 3 |
| 5 | 儿童幽门螺杆菌粪便抗原检测显示文摘幽门螺杆菌(Hp)感染是导致胃十二指肠疾病的重要原因,可引起胃炎、消化道溃疡、胃癌等胃十二指肠疾病。临床上对Hp具有多种检测方法。Hp粪便抗原检测是近年来一种新的非侵入性的Hp检测方法,具有操作简单、安全方便、性价比高、易被患者接受等优点,尤其适用于儿童Hp感染的检测。现就Hp粪便抗原检测试验原理、方法、影响因素及与其他检测方法的对比,以及在Hp感染的诊断、随访及流行病学调查等方面的应用加以综述。 | 雷小雨 王大利 贺美玲 孙玉婵 | 2018 | 医学综述2018，24，16： | 2 |
| 6 | Retrospective analysis of discordant results between histology and other clinical diagnostic tests on helicobacter pylori infection显示文摘BACKGROUND A reliable test is essential for diagnosing Helicobacter pylori(H.pylori)infection,and crucial for managing H.pylori-related diseases.Serving as an excellent method for detecting H.pylori infection,histologic examination is a test that clinicians heavily rely on,especially when complemented with immunohistochemistry(IHC).Additionally,other diagnostic tests for H.pylori,such as the rapid urease test(CLO test)and stool antigen test(SA),are also highly sensitive and specific.Typically,the results of histology and other tests align with each other.However,on rare occasions,discrepancy between histopathology and other H.pylori diagnostic tests occurs.AIM To investigate the discordance between histology and other H.pylori tests,the underlying causes,and the impact on clinical management.METHODS Pathology reports of gastric biopsies were retrieved spanning August 2013 and July 2018.Reports were included in the study only if there were other H.pylori tests within seven days of the biopsy.These additional tests include CLO test,SA,and H.pylori culture.Concordance between histopathology and other tests was determined based on the consistency of results.In instances where histology results were negative while other tests were positive,the slides were retrieved for re-assessment,and the clinical chart was reviewed.RESULTS Of 1396 pathology reports were identified,each accompanied by one additional H.pylori test.The concordance rates in detecting H.pylori infection between biopsy and other tests did not exhibit significant differences based on the number of biopsy fragments.117 discrepant cases were identified.Only 20 cases(9 with CLO test and 11 with SA)had negative biopsy but positive results in other tests.Four cases initially stained with Warthin-Starry turned out to be positive for H.pylori with subsequent IHC staining.Among the remaining 16 true discrepant cases,10 patients were on proton pump inhibitors before the biopsy and/or other tests.Most patients underwent treatment,except for two who were untreated,and two patients who were lost to follow-up.CONCLUSION There are rare discrepant cases with negative biopsy but positive in SA or CLO test.Various factors may contribute to this inconsistency.Most patients in such cases had undergone treatment. | Xiaohua Qi Kevin Kuan Tony El Jabbour Yungtai Lo Qiang Liu Yanan Fang | 2024 | World Journal of Gastrointestinal Endoscopy2024，16，2： | 0 |
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