在老年人中消除Helicobacter pylori:系统性审查和元分析
Sun Jae Moon1,2, Ah Young Lee3, Jinseub Hwang4
1Department of Gastroenterology, Bundang Jesaeng General Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.
Helicobacter
|August 8, 2025
概括
在老年人中,Helicobacter pylori根除疗法显示出不同的疗效. 评估根除史以打击抗生素耐药性,并考虑国家特定的胃癌预防策略.
科学领域:
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
- 老年病的医生 老年病的医生
背景情况:
- 杆菌 (H. pylori) 感染很常见,有效的根除策略至关重要,特别是在老年人群中.
- 了解老年人H. pylori根除的临床影响,疗效,不良事件和抗生素耐药性模式对于优化治疗至关重要.
研究的目的:
- 评估H. pylori根除疗法的临床效果,疗效,不良事件,耐受性和抗生素耐药性,针对60岁及以上的个体.
- 为了比较不同H. pylori根除方案在老年人群中的有效性.
主要方法:
- 在多个数据库 (Medline,Embase,CINAHL,Cochrane图书馆等) 进行了系统的文献搜索. ) 的情况.
- 包括的研究是随机对照试验 (RCT) 或与60岁或以上的参与者进行的队列研究,重点是定量疗效指数.
- 使用随机效应模型进行了元分析,以从选定的研究中汇集数据.
主要成果:
- 审查了64项研究,其中10天的顺序疗法实现了91%的根除率,7天的标准三重疗法实现了81%的根除率.
- 基于诺普拉桑的7天疗法和基于木的14天疗法的疗法显示,根除率≥95%.
- 抗生素耐药性随着先前根除史的增加,在一些队列中注意到对胃癌的保护作用,因地区和年龄而异.
结论:
- 标准的7天三重疗法对于老年人根除H. pylori是不够的;10天的连续疗法是可以接受的边界.
- 根除病史是影响抗生素耐药性的关键因素,需要仔细评估.
- 虽然报告了胃癌的保护作用,但需要针对特定国家和条件的建议,并呼吁更严格地报告不良事件和耐药性.
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