% ~ 3% 15 Hp 1. Hp Hp < 45 Hp 8. NSAIDs Hp NSAIDs UBT Hp HpSA Hp 16 Hp NSAIDs NSAIDs Hp 17 Hp NSAIDs gastroesophageal

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1 618 Chin J Gastroenterol 2012 Vol. 17 No. 10 中华医学会消化病学分会幽门螺杆菌学组 / 全国幽门螺杆菌研究协作组 1 刘文忠陈谢 4 烨 2 勇成 6 曾志荣 3 虹 2 王崇文 2* 吕农华 1 萧树东 3 胡伏莲 7 潘国宗 4 张万岱 6 胡品津 5 周丽雅 NUD functional dyspepsia FD Hp NUD ~ 27 FD Helicobacter pylori Hp NUD FD 40 NUD Hp 4 Hp Hp Hp 1 /12 ~ 1 /5 Hp FD Hp 4. Hp < 1% 8 9 Hp Hp Hp 1. Hp Hp 5. Hp MALT Hp 12 80% Hp Hp MALT Hp 6. PPI Hp 2 Hp Hp PPI 13 MALT 3 PPI 3. Hp ph Hp Hp non-ulcer dyspepsia DOI /j. issn * lunonghua@ 163. com Hp 14 PPI

2 % ~ 3% 15 Hp 1. Hp Hp < 45 Hp 8. NSAIDs Hp NSAIDs UBT Hp HpSA Hp 16 Hp NSAIDs NSAIDs Hp 17 Hp NSAIDs gastroesophageal reflux disease 3 Hp PPI 17 GERD Hp GERD 9. Hp Hp Hp GERD 18 Hp 50% GERD idiopathic thrombocytopenic purpura Hp GERD Hp Hp Ménétrier Hp GERD Hp Hp Hp GERD Hp PPI 10. < 45 PPI Hp Hp 45 Hp Hp 1 Hp 1 Hp Hp MALT PPI NSAIDs Hp Ménétrier

3 620 Chin J Gastroenterol 2012 Vol. 17 No. 10 Hp UBT 3 good practice point 28 Hp 6. Hp IgG Hp CagA VacA Hp CagA Hp RUT MALT HE 7. Warthin-Starry Giemsa Hp Hp Hp PCR Hp 13 C- 14 C-UBT HpSA Hp Hp 1. RUT ph E-test Hp 1. Hp RUT 2. Hp 2 13 C- 14 C-UBT HE 3HpSA Hp HE FISH Hp Hp UBT Hp 1 13 C- 14 C-UBT 2 HpSA 3 4. UBT RUT 3 Hp 1. Hp 1 RUT 2. Hp Hp RUT UBT HpSA

4 Hp + PPI UBT Hp 31 Maastricht-4 3 RUT HpSA 6. Hp Hp NSAIDs Hp > 95% Hp d 14 d 5% 3 3. PPI 45 Hp Hp 46 3 sequential therapy 5 d PPI + 5 d PPI d concomitant therapy PPI > 15% ~ 20% Pylera Hp % ~ 60% 32 6 Hp 60% ~ 70% % ~ 38% 33 ~ 35 30% ~ 1 ~ 2 38% %~ 5% 33 ~ Hp Hp 2. Hp 6 PPI + + PPI % 37 ~ 39 7 d 7. 1PPI + + 2PPI + + 3PPI PPI % ~ 14% 47 ~ 50 + PPI d

5 622 Chin J Gastroenterol 2012 Vol. 17 No PPI + + PPI rescue therapy 51 ~ 53 + PPI d 14 d d MALT Hp NUD 2 initial therapy Hp 2. PPI d 14 d 1. 2 ~ * mg 2 /d 500 mg 2 /d mg 2 /d 500 mg 1 /d 200 mg 2 /d mg 2 /d 100 mg 2 /d 4a 4b 750 mg 2 /d 400 mg 2 /d 3 /d 750 mg 2 /d 100 mg 2 /d * PPI + 2 /d 0. 5 h + 2 PPI 20 mg 10 mg Maastricht 20 mg 20 mg 30 mg 40 mg 2 /d 220 mg 2 /d

6 PPI ( 西安市中心医院 ) ; 张玲霞 ( 西安市中心医院 ) ; 张 PPI 万岱 ( 南方医科大学南方医院 ) ; 张振玉 ( 南京市第 CYP2C19 一医院 ) ; 郑鹏远 ( 郑州大学第二附属医院 ) ; 周丽雅 CYP2C19 PPI ( 北京大学第三医院 ) ; 祝荫 ( 南昌大学第一附属医院 ) 1. Hp 3 1 Lang L. Barry Marshall 2005 Nobel laureate in medicine 2. and physiology J. Gastroenterology Hp Gisbert JP Calvet X. Review article common misconceptions in the management of Helicobacter pylori-associated gastric 3. MALT-lymphoma J. Aliment Pharmacol Ther Hp Malfertheiner P Megraud F O Morain CA et al. 4. Hp Hp Management of Helicobacter pylori infection -- the Maastricht Ⅳ /Florence Consensus Report J. Gut Malfertheiner P Megraud F O Morain C et al. Current 陈晓宇 ( 上海交通大学医学院附属仁济医院 ) ; concepts in the management of Helicobacter pylori infection the Maastricht Ⅲ Consensus Report J. Gut 陈烨 ( 南方医科大学南方医院 ) ; 成虹 ( 北京大学第一医院 ) ; 杜勤 ( 浙江大学医学院附属第二医院 ) ; 房 5 Moayyedi P Soo S Deeks J et al. Systematic review and 殿春 ( 第三军医大学西南医院 ) ; 房静远 ( 上海交通 economic evaluation of Helicobacter pylori eradication 大学医学院附属仁济医院 ) ; 郜恒骏 ( 同济大学附属 treatment for non-ulcer dyspepsia. Dyspepsia Review 同济医院 ) ; 郭晓钟 ( 沈阳军区总医院 ) ; 韩英 ( 北京军区总医院 ) ; 胡伏莲 ( 北京大学第一医院 ) ; 胡仁伟 ( 四川大学华西医院 ) ; 姜葵 ( 天津医科大学总医院 ) ; 蒋树林 ( 河北医科大学第二医院 ) ; 李晓燕 ( 昆明医学院第一附属医院 ) ; 李岩 ( 中国医科大学附属 6 Group J. BMJ Jin X Li YM. Systematic review and meta-analysis from Chinese literature the association between Helicobacter pylori eradication and improvement of functional dyspepsia J. Helicobacter Talley NJ Vakil NB Moayyedi P. American gastroenterological association technical review on the evaluation 盛京医院 ) ; 梁浩 ( 解放军总医院 ) ; 刘文忠 ( 上海交通大学医学院附属仁济医院 ) ; 陆红 ( 上海交通大学 of dyspepsia J. Gastroenterology 医学院附属仁济医院 ) ; 吕农华 ( 南昌大学第一附属医院 ) ; 潘国宗 ( 中国医学科学院北京协和医学院 8 Correa P Houghton J. Carcinogenesis of Helicobacter pylori 北京协和医院 ) ; 任建林 ( 厦门大学附属中山医院 ) ; 舒徐 ( 南昌大学第一附属医院 ) ; 王崇文 ( 南昌大学第一附属医院 ) ; 王江滨 ( 吉林大学中日联谊医院 ) ; 王学红 ( 青海大学附属医院 ) ; 谢勇 ( 南昌大学第一 9 10 J. Gastroenterology J Rokkas T Pistiolas D Sechopoulos P et al. The longterm impact of Helicobacter pylori eradication on gastric 附属医院 ) ; 许建明 ( 安徽医科大学第一附属医院 ) ; histology a systematic review and meta-analysis J. 徐三平 ( 华中科技大学同济医学院附属协和医院 ) ; Helicobacter Suppl 杨桂彬 ( 航天中心医院 ) ; 杨昭徐 ( 首都医科大学附 11 Wang J Xu L Shi R et al. Gastric atrophy and intestinal 属北京天坛医院 ) ; 曾志荣 ( 中山大学附属第一医院 ) ; 张桂英 ( 中南大学湘雅医院 ) ; 张国新 ( 江苏省人民医院 ) ; 张建中 ( 中国疾病预防控制中心 ) ; 张沥 12 metaplasia before and after Helicobacter pylori eradication a meta-analysis J. Digestion Fukase K Kato M Kikuchi S et al. Effect of eradication

7 624 Chin J Gastroenterol 2012 Vol. 17 No. 10 of Helicobacter pylori on incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer an open-label randomised controlled trial J. Lancet Kuipers EJ Lundell L Klinkenberg-Knol EC et al. Atrophic gastritis and Helicobacter pylori infection in patients with reflux esophagitis treated with omeprazole or fundoplication J. N Engl J Med Hagiwara T Mukaisho K Nakayama T et al. Long-term proton pump inhibitor administration worsens atrophic corpus gastritis and promotes adenocarcinoma development in Mongolian gerbils infected with Helicobacter pylori J. Gut Fitzgerald RC Hardwick R Huntsman D et al. Hereditary diffuse gastric cancer updated consensus guidelines for clinical management and directions for future research J. J Med Genet Huang JQ Sridhar S Hunt RH. Role of Helicobacter pylori infection and non-steroidal anti-inflammatory drugs in peptic-ulcer disease a meta-analysis J. Lancet Vergara M Catalán M Gisbert JP et al. Meta-analysis role of Helicobacter pylori eradication in the prevention of peptic ulcer in NSAID users J. Aliment Pharmacol Ther Yuan W Li Yumin Yang Kehu et al. Iron deficiency anemia in Helicobacter pylori infection meta-analysis of randomized controlled trials J. Scand J Gastroenterol Stasi R Sarpatwari A Segal JB et al. Effects of eradication of Helicobacter pylori infection in patients with immune thrombocytopenic purpura a systematic review J. Blood Madisch A Miehlke S Neuber F et al. Healing of lymphocytic gastritis after Helicobacter pylori eradication therapy -- a randomized double-blind placebo-controlled multicentre trial J. Aliment Pharmacol Ther Ji F Wang ZW Ning JW et al. Effect of drug treatment on hyperplastic gastric polyps infected with Helicobacter pylori a randomized controlled trial J. World J Gastroenterol Fock KM Katelaris P Sugano K et al. Second Asia- Pacific Consensus Guidelines for Helicobacter pylori infection J. J Gastroenterol Hepatol Li XB Liu WZ Ge ZZ et al. Helicobacter pylori testand-treat strategy is not suitable for the management of patients with uninvestigated dyspepsia in Shanghai J. Scand J Gastroenterol Saad AM Choudhary A Bechtold ML. Effect of Helicobacter pylori treatment on gastroesophageal reflux disease GERD meta-analysis of randomized controlled trials J. Scand J Gastroenterol Qian B Ma S Shang L et al. Effects of Helicobacter pylori eradication on gastroesophageal reflux disease J. Helicobacter Nam SY Choi IJ Ryu KH et al. Effect of Helicobacter pylori infection and its eradication on reflux esophagitis and reflux symptoms J. Am J Gastroenterol Yaqi S Okada H Takenaka R et al. Influence of Helicobacter pylori eradication on reflux esophagitis in Japanese patients J. Dis Esophagus World Gastroenterology Organisation. World Gastroenterology Organisation Global Guideline Helicobacter pylori in developing countries J. J Clin Gastroenterol Yilmaz O Demiray E Tümer S et al. Detection of Helicobacter pylori and determination of clarithromycin susceptibility using formalin-fixed paraffin-embedded gastric biopsy specimens by fluorescence in situ hybridization J. Helicobacter Gisbert JP Pajares JM. Review article 13 C-urea breath test in the diagnosis of Helicobacter pylori infection -- a critical review J. Aliment Pharmacol Ther Tian XY Zhu H Zhao J et al. Diagnostic performance of urea breath test rapid urea test and histology for Helicobacter pylori infection in patients with partial gastrectomy a meta-analysis J. J Clin Gastroenterol J /. J Song Z Zhou L Wang Y et al. A study to explore Hp antibiotic resistance and efficacy of eradication therapy in china multi-center nation-wide randomized control study abstract J. Helicobacter Suppl

8 Sun QJ Liang X Zheng Q et al. Resistance of Helicobacter pylori to antibiotics from 2000 to 2009 in Shanghai J. World J Gastroenterol Mégraud F Lehours P. Helicobacter pylori detection and antimicrobial susceptibility testing J. Clin Microbiol Rev Yan X Zhou L Song Z et al. Sequential therapy for Helicobacter pylori eradication in adults compared with triple therapy in china a multiplecenter prospective randomized controlled trial abstract J. Helicobacter Suppl Zheng Q Chen WJ Lu H et al. Comparison of the efficacy of triple versus quadruple therapy on the eradication of Helicobacter pylori and antibiotic resistance J. J Dig Dis Malfertheiner P Bazzoli F Delchier JC et al. Helicobacter pylori eradication with a capsule containing bismuth subcitrate potassium metronidazole and tetracycline given with omeprazole versus clarithromycin-based triple therapy a randomised open-label non-inferiority phase 3 trial J. Lancet Minakari M Davarpanah Jazi AH Shavakhi A et al. A 40 Kadayifci A Uygun A Polat Z et al. Comparison of randomized controlled trial efficacy and safety of bismuth-containing quadruple and concomitant therapies as a first-line treatment option for Helicobacter pylori J. Turk J Gastroenterol azithromycin ofloxacin bismuth and omeprazole compared with amoxicillin clarithromycin bismuth and omeprazole as second-line therapy in patients with Helicobacter pylori 41. infection J. Helicobacter J Mégraud F. The challenge of Helicobacter pylori resistance to antibiotics the comeback of bismuth-based quadruple therapy J. Therap Adv Gastroenterol Baker DE. Pylera plus omeprazole quadruple treatment for Helicobacter pylori J. Rev Gastroenterol Disord Ford AC Malfertheiner P Giguere M et al. Adverse events with bismuth salts for Helicobacter pylori eradication systematic review and meta-analysis J. World J Gastroenterol Fischbach LA van Zanten S Dickason J. Meta-analysis the efficacy adverse events and adherence related to firstline anti-helicobacter pylori quadruple therapies J. Aliment Pharmacol Ther Sun Q Liang X Zheng Q et al. High efficacy of 14-day triple therapy-based bismuth-containing quadruple therapy for initial Helicobacter pylori eradication J. Helicobacter J J Lv NH Xie Y Guo XB et al. Eradication therapy for Helicobacter pylori infection in patients with duodenal ulcers based on furazolidone triple and quadruple therapy a multicenter randomized controlled trial abstract J. Helicobacter Suppl Ghadir MR Shafaghi A Iranikhah A et al. Furazolidone amoxicillin and omeprazole with or without bismuth for eradication of Helicobacter pylori in peptic ulcer disease J. Turk J Gastroenterol Gu LY Lin WW Lu H et al. Quadruple therapy with medications containing either rufloxacin or furazolidone as a rescue regimen in the treatment of Helicobacter pyloriinfected dyspepsia patients a randomized pilot study J. Helicobacter J Hunfeld NG Touw DJ Mathot RA et al. A comparison of the acid-inhibitory effects of esomeprazole and rabeprazole in relation to pharmacokinetics and CYP2C19 polymorphism J. Aliment Pharmacol Ther Anagnostopoulos GK Tsiakos S Margantinis G et al. Esomeprazole versus omeprazole for the eradication of Helicobacter pylori infection results of a randomized controlled study J. J Clin Gastroenterol J J

Guidelines: Helicobacter Pylori in developing countries (Chinese)

Guidelines: Helicobacter Pylori in developing countries (Chinese) WGO-OMGE 临床指南发展中国家幽门螺杆菌感染杜颖丛衍群译戴宁 ( 官方特约翻译 ) 审校浙江大学医学院附属邵逸夫医院消化科 (310016) 编写组 : R H Hunt 教授, 主席, 加拿大 S D Xiao 教授, 中国 F Megraud 教授, 法国 R Leon-Barua