【译文】幽门螺旋杆菌(HP)一种全球常见多持续终生的疾病。建议对消化性溃疡、胃癌或胃粘膜相关淋巴组织淋巴瘤患者,检测HP。其他需要考虑检测HP的适应症包括消化不良、长期服用非甾体类抗炎药或阿司匹林、原因不明的缺铁性贫血和免疫性血小板减少症。HP检测可通过直接内窥镜活检标本,或粪便抗原或尿素呼气试验。质子泵抑制剂会干扰检测幽门螺杆菌的结果,HP检测之前必须停止服药。HP结果阳性有几种初始治疗方案。选择治疗方案时,要考虑患者是否对青霉素过敏,是否使用大环内酯类药物及生活或者曾生活在大环内酯类抗药率高的地区。治疗后,必须确证根除HP,通常是在抗生素治疗完成1个月后粪便抗原测试或尿素呼气测试(同样不服用质子泵抑制剂时检测)。如果需要进行再治疗,建议采用不同的治疗方案,避免使用相同的抗生素。

【原文】Helicobacter pylori infection is a common, usually lifelong, infection that is found worldwide. Testing for H. pylori is recommended in patients with peptic ulcer disease, gastric cancer, or gastric mucosa-associated lymphoid tissue lymphoma (MALToma). Other recommended indications for testing include dyspepsia, prolonged use of nonsteroidal antiinflammatory drugs or aspirin, unexplained iron-deficiency anemia, and immune thrombocytopenia. Testing for H. pylori can be performed directly on biopsy specimens obtained during endoscopy or performed by means of the stool antigen test or urea breath test. Proton-pump inhibitors interfere with the detection of bacteria and must be discontinued before any testing is performed. Several regimens are considered to be acceptable for initial treatment. The presence of an allergy to penicillin, previous exposure to macrolides, and high levels of macrolide resistance where the patient lives or has lived (if information is known) are relevant in choosing a regimen. After treatment, it is essential to document clearance of the infection, typically by means of a stool antigen test or urea breath test performed 1 month after the completion of antibiotic therapy(again, while the patient is not taking a Proton-pump inhibitors). Should retreatment be indicated, a different regimen that avoids repetitive use of the same antibiotic agents is recommended.