Клинические рекомендации по лечению язвы желудка
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, . Helicobacter pylori, . – . – . , . .. . .. , .. , .. , .. , .. . , , , (- , ), . , , . , . , Helicobacter pylori (HP) ( ) . . , , .. , , . , – . , ( – ). . , ( ), , . , ( ) . , , () , – () – . 5 15% ( 7-10%). 4 , . , . , , (). , – . ( , , ), , ( ), . , , , . ( , , ), (, , ), , . , Helicobacter pylori (), 1983 . . (B.Marshall) . (J.Warren). 90-95% 70-85% . . (, , ), , . V- , , , CagA-, , . 128 , . , , , . . , , , , ( ), . , ( , 0(I) , , – , , .), . 5-10% 15-20% . , . . , , . ( , , , ), ( ), . , . , – ( 0,5 ), (0,6-1,9 ) , (2,0-3,0 ) ( 3,0 ) . : , ( “” “” ) , – . (, , , , – ), , . , , . ( ), – ( ), ( 2-3 ), , , . , , . : , , , . , , . . ( ) . , , , , . . , 30%. , . ( ), . . , , . ( , ). . , , . , – ( – ). ( – ) , – . . . – “” ( ” “, “”, – , , ). , , , , , , , . , . , , , (.). . 1. Helicobacter pylori
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2- 3- | 7 . ( ) 400 2 – ( 250 4 500 2 ) ( 500 4 ), 7 14 . , , , ( 30% ) ( 10% ). , . , , , , , 93% 91% 76% 61%. , , – 44-69%. . , (, ) 7 10-14 . ( ) 500 1000 . , , . , , 21-22 2000 . Helicobacter pylori (2). , . , . , ( ) 2 + ( 500 2 ) + ( 1000 2 ) ( 500 2 ). , , . , 4-6 ( ). ” ” , , , , . 4-6 . (1). 4 , ( 2 ), ( ) ( 1,5 ) ( 2 ). . 7 . . : (.. 2 ) (, 12 ). , , , , , , “” (compliance), .. , , (8). , , , : , 70% 4-5% , , , -2 (, ), “” , “” ( , .). , , , , “” , , – (8). , 2-3 , . , . ( ) . , . , , , . , (5). . , -2, . . 1. Helicobacter pylori // , , . – 1998. – 1. – .105-107. 2. Helicobacter pylori, ( 21-22 2000 ) // , , . – 2000. – 6 – .7-9. 3. .., .., .. . 13- // “Helicobacter pylori: ” ( . .., ., ..). – . – 1999. – .131-139. 4. Besancon M., Simon A., Sachs A., Shin J.M. Sites of reaction of the gastric H,K-ATPase with cytoplasmic thiol reagents // J.Biol. Chem. – 1997. – Vol.272. – P.22438-22446. 5. Blum A.L. Perspektiven der Therapie mit Protonenpumpemblockern (PP-Blocker) // Z.Gastroenterol. – 1995. – Vol.33. – Suppl.1. – P.32-40. 6. Burget D.W., Chiverton K.D., Hunt R.H. Is there an optimal degree of acid supression for healing of duodenal ulcers? A model of the relationship between ulcer healing and acid supression // Gastroenterology. – 1990. – Vol.99. – P.345-351. 7. Leodolter A., Megraud F. Diagnosis of Helicobacter pylori infection // Current opinion in gastroenterology.- 2001. – Vol.17, suppl.1.- S.19- S.23. 8. Soll A.H. Peptic ulcer and its complications // Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. – Philadelphia-Londom-Toronto-Montreal-Sydney-Tokyo. – 1998. – Vol.1. – P. 620-678 |
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