幽门螺杆菌感染处理马斯特里赫特IV佛罗伦萨共识报告.pdfVIP

Management of Helicobacter pylori infection － the Maastricht IV/ Florence Consensus Report 幽门螺杆菌感染的处理－ 马斯特里赫特IV/佛罗伦萨共识报告 Malfertheiner P, et al. Gut 2012; 61: 646-664 （上海交通大学医学院附属仁济医院消化科 刘文忠 教授译） WORKSHOP 1 工作小组 1 (Indications and contraindications for diagnosis and treatment) (诊断、治疗指证和反指证) Statement 1: A test-and-treat strategy is appropriate for uninvestigated dyspepsia in populations where the H. pylori prevalence is high (20%). This approach is subject to local cost-benefit considerations and is not applicable to patients with alarm symptoms, or older patients (age to be determined locally according to cancer risk) [Evidence level:1a, Grade of recommendation: A] 检测和治疗策略对幽门螺杆菌感染率高于 20%人群中未经调查的消化不良 者是合适的。这一方法应考虑当地的费用-效益比，不适用于有报警症状患者或 老年患者（年龄应根据当地癌症风险确定）[证据水平:1a, 推荐级别: A] Statement 2: The main non-invasive tests that can be used for the test-and-treat strategy are the UBT and monoclonal stool antigen tests. Certain validated serological tests can also be used.[2a,B] 用于检测和治疗策略的主要非侵入性试验是尿素呼气试验（UBT）和单克隆 粪便抗原试验。也可用某些已经过验证的血清学试验。[2a，B] Statement 3: H. pylori eradication produces long-term relief of dyspepsia in one of 12 patients with H.pylori and functional dyspepsia; this is better than any other treatment.[1a,A] 根除幽门螺杆菌可使 1/12 幽门螺杆菌阳性功能性消化不良患者有长期的症 状缓解，这一疗效优于其他任何治疗。[1a,A] Statement 4: H. pylori can increase or decrease acid secretion depending on the intragastric distribution of inflammation.[2b,B] 幽门螺杆菌感染可以增加或降低胃酸分泌，这取决于胃内炎症的分布。 [2b,B] Statement 5: On average, H.pylori status has no effect on symptom severity, symptom recurrence and treatment efficacy in GORD. H. pylori eradication does not exacerbate pre-existing GORD or affect treatment efficacy.[1a,A] 平均而言，幽门螺杆菌状态对胃食管反流病（GERD ）症状的严重性、症状复 发和治疗效果无影响。根除幽门螺杆菌不会加重原本已存在的 GERD，不会影响 治疗效果。[1a,