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【慧·健康】幽门螺旋杆菌，要不要治？2023-12-27 16:25·吉林乡村广播幽门螺旋杆菌慧养生 会健康现在不少常规体检中，都有对于幽门螺杆菌（Hp）检验，而检查者看到结果显示“阳性”，大多数会感到紧张。那幽门螺杆菌感染到底有什么危害呢？需不需要治疗呢？嘉宾李雨静吉林省人民医院消化内二科主任医师幽门螺旋杆菌什么是幽门螺旋杆菌幽门螺旋杆菌（H. pylori）是一种螺旋形革兰阴性杆菌，常寄生于胃部黏膜上皮细胞内，生活在胃黏膜中，是引起许多胃病和消化道疾病的常见病原体之一。幽门螺旋杆菌类型依据是否表达VacA和CagA毒素，将其分为两型：1Ⅰ型毒性较强，对病人危害较大，与慢性萎缩性胃炎，胃、十二指肠溃疡及胃癌、胃黏膜相关淋巴组织淋巴瘤的发生率密切相关。2Ⅱ型毒性较小，致病力弱，一般表现为轻微消化不良，也可引起慢性萎缩性胃炎。幽门螺杆菌抗体分型检测可以同时检测 CagA、VacA、UreB及 UreA 等多项毒力因子，在判断是否感染幽门螺杆菌的同时将其进行分型。不干预会有哪些后果与幽门螺旋杆菌密切相关的疾病有急性、慢性胃炎、消化性溃疡（胃溃疡和十二指肠球溃疡）、胃癌、胃黏膜相关淋巴组织淋巴瘤。多表现为上腹部疼痛，多为隐痛，进食后加重，有胸骨后烧灼感、腹胀、恶心、反酸，溃疡严重者可有消化道出血，多表现为黑便，可有呕血。出血量多者可有心悸、晕厥、烦躁、血压下降，甚至休克等。幽门螺旋杆菌感染后除菌的用药根除Hp的方案有多种， 目前我国指南推荐标准四联疗法，即1种质子泵抑制剂xx拉唑+1种铋剂+2种抗生素。质子泵抑制剂（PPI）：如奥美拉唑，抑制胃酸，为抗生素发挥杀菌作用创造酸度低的胃内环境。铋剂：如胶体果胶铋，可增加对幽门螺旋杆菌耐药菌株的根除作用。抗生素：目前有证据支持的用于幽门螺旋杆菌治疗的抗生素有阿莫西林、克拉霉素、左氧氟沙星、甲硝唑、呋喃唑酮、四环素，从中选取2种敏感的抗生素。如何选取正确的药物需咨询专业医师，如果没有相关禁忌，医生一般会根据个体情况从中组合选择根除率相对最高的方案。治疗用药期间的注意事项1除菌方案中有铋剂，会使大便呈黑色，同时口腔内粘膜和舌粘膜出现黑色，告知患者不要误以为消化道出血，出现恐慌和不必要的就诊。2服用抗生素会出现腹胀、恶心和腹泻等胃肠道反应，如能耐受请坚持完成除菌疗程。3服用抗生素期间不能饮酒以免出现中毒反应。除菌疗程结束后1个月才能再次复查呼气试验检查确定是否除菌成功，提前复查会出现加阴性的结果。观看直播关注吉林乡村广播观看视频直播邀请您每周一至周六上午9:30—10:30收听、收看公益养生栏目《慧养生 会健康》文章来源：吉林乡村广播编辑：慧宇 冬雪部分素材来源于网络，如有侵权，请联系我们，谢谢010203可天有不测风云。
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马生摇摇头说：我对她没感觉一点感觉也没有
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