Ю.. Ш, Я О ,....,,,..,, 2017

Transcription

1 Ю.. Ш, Я О ,....,,,,.., 2017

2 А 35, 8, 40.,,,...

3 А Helicobacter pylori !....!

4 , Helicobacter pylori,, 50 60% [1, 5]. ( ) - [10]. 5% - 30, 30% % - 50 [18].,,,, [11]. ( ) (14,7 %) (10,8 %),, 980 [16]., Helicobacter pylori (H. pylori ) [1-3]. G-, [3-4]. H. pylori [3]. H. pylori, 3

5 твета [1, 9, 14, 15]. ( -8, -12),, [9, 16, 20].,, - [2, 20 ]., ( ) [15]. [13, 15].,, [18]., [18, 20].., : 1.. 4

6 2.. (...). 5

7 1 1.1 А (. Gastritis atrophica) ( ). :,, -, [10]. -,,,,, [10, 18,19]., 4, 15 [10].,,,, ( )., -.,, [10, 17]. 6

8 ,,. Helicobacter pylori (. pylori).,. pylori,, [15, 19].,..,,.. ylori -, [19]. [19, 20]. 1.2 [3-7]., elicobacter pylori (. ylori) -, - [7]. (, 7

9 ) ( ) ( ) [15]. ( ) ( ),,. [5]., :. ylori; Helicobacterpylori.,,,,,. [2-5]; (, ); ; ;, ; ;. : ; (, ( ).,,,, [19]. ( ). : ;, ; 12-8

10 ; G- [12,19]. 1.3,.,,, : [5, 9]. 1.,,, [9] ,,,,, 12.,,,.,. [9].,,,,. (,,, )[19]

11 , -.,, [22, 24].. Helicobacter pylori (. l ri),.,. l ri,, :. l ri, [22-25].. Correa. :. l ri [25, 27]. 10

12 1 ( ) 1.5 А a a a (IARC) H. pylori,, ( ). a - Helicobacter pylori (H. Pylori). H. Pylori a, a [27, 29]. H. Pylori a, a [1, 26, 30]. ( 60-80% ) 11

13 , H. Pylori. 2-6, [35]. -.,.,., -, %., caga - H. pylori.,,, [37]. o.,, a, [29]. o - a. o, o o [20]. -, 25% 12

14 .,,. H.pylori, ( ) [1, 25]. 80% H.pylori - -, 20% H.pylori -, 10% 10% -,, [1]., [12, 38].,,. -, [9, 26].,. -,. ( ) [17-18]. 1.6 А. 13

15 : 1.. ( ),,,,,.. [8,19] ,,, [19]. 3..,.., [12]. 4.,,.., ( ) [5]. : 1.. (.)[5] 2.. (,,,, 14

16 Helicobacter pylori,, )[3] [3].,.,,..,..,. pylori- (Cag A+ Vac A+). pylori [1-3] ( ).,, (,..),.,,,.,,, [27]., -, 15

17 . [25]..,, [15].,, : -,,, -., [15].,., -,,, -,, [17]. 2 : I (PGI) II (PGII). I. II., I II, [17]. I,. II,,. ( ) [17]., PGI 50 / [1]. 16

18 ,, PGI 25 /. PGI ( ),. 90%,, /,,,. 15 /, -,. - PGI/PGII, 3 [5, 17]. -. G-,,., -17, -13, 34.., -17 ( ) 34 ( )., : ( ); ; (, ) [13]. 17

19 : 3 7, -..,, % ( ). [39].,.,,,..,,.. [15]. 1.8 Helicobacter pylori Helicobacter pylori, [1]. (IARC) H. pylori,, ( ). - Helicobacter pylori (H. Pylori). 18

20 H. Pylori, [1-3]. Helicobacter pylori - [2].,,, Helicobacter pylori, ( ),,, [2-4]. H. pylori,. H. pylori,,,.., H. pylori. -,, ( ).,. 19

21 ph ( 6-7). 20

22 ,. ( 45,1+3,1 ), ,. (...,..).,, g,

23 5. ( * 11 * 1000)/0,02=( 2/ ) 1-1, - 5, 2-1 ( 2*106). : (, - ), ( ), 100 /. : 200, 20, 240, ,, «L3604» Tmax, Imax, Smax ( ),. ( ) «CL3604» ( ) (De sole p.et al.; 1983). (Tmax), (Imax) (S)., [20 25]. MS Excel. Statistica 7.0 (StatSoft, USA).. (Me) 22

24 ( 25 75). - (p<0.05). 23

25 ,. 24

26 АЩ H. pylori - Helicobacter pylori

27 А Ч 1,.. H. pylori /.. // , ,.. /.. //, ,.. /.. // ,.. /.. // ,.. - /.. //. 3 (91), ( ) , ,.. : /.. //.....: -, ,.. /..,.. //. - :, ,.. - I II -17 /.. // C ,.. 26

28 /.... //, 2 (39), ( ) ,.. :. /.. //, 28, ( ) ,.. /.. //, 1 (01), ( ) , /.. //.,, , /.. // , , , ,.. H. Pylori /.. //, 2, ( ), ,.., ,

29 17,.. I, II -17 /..,..,.. [.] // , // /.. //, 4, ( ) , (. ) /.. //, 12, ( ). 2010, ,.. Helicobacter pylori. /.. // , Blaser, M. J. Hypothesis: the changing relationships of Helicobacter pylori and humans: implications for health and disease./ M. J. Blaser // Infect. Dis P Go, M.F. Natural history and epidemiology of Helicobacter pylori infection/ M.F. Go// Aliment Pharmacol. Ther (Suppl. 1). - P Megraud, F. Seroepidemiology of Campylobacterpylori infection in various populations/ F Megraud [et al.]. // Clin. Microbiol P Graham, D.Y. Ablation of exaggragated meal-stimulated gastrin release in duodenal ulcer patients after clearance of Helicobacter pylori infection/ Graham, D.Y. Graham [et al.]. // Gastroenterol P Correa P. Gastric cancer: overview/ P. Correa // Gastroenterol. Clin. North Vol. 42, 2. - P

30 27 Xue-Gong, F. WN Keeling, Enhanced T-helper 2 lymphocyte responses: immune mechanism of Helicobacter pylori infection/ Xue-Gong, F. [et al.]. // IrJ. Med. Sci P Macarena, B Modulation of the CD41 T-Cell Response by Helicobacter pylori Depends on Known Virulence Factors and Bacterial Cholesterol and Cholesterol a-glucoside Content / Macarena, B [et al.]. // Infect Dis P Kido, M. Helicobacter pylori promotes the production of thymic stromal lymphopoietin by gastric epithelial cells and iduces dendritic cell-mediated inflammatory Th2 responses/ M. Kido, J. Tanaka // Infect. Immun P Versalovic, J. Helicobacter pylori: Pathology and Diagnostic Stratedies / J. Versalovic [et al.]. // ClinPathol P Versalovic, J. Helicobacter pylori: Pathology and Diagnostic Stratedies / J. Versalovic [et al.]. // ClinPathol P Garhart, C. A. Vaccine-induced reduction of Helicobacter pylori colonization in mice is interleukin-12 dependent but gamma interferon and inducible nitric oxide synthase independent/ C. A. Garhart, F. Heinzel [ et al.]. // Infect immune P Becher, D. [et. al.] Local recall responses in the stomach involving reduced regulation and expanded help mediate vaccine-induced protection against Helicobacter pylori in mice. Eur. / D. Becher [et. al.]. // J. Immunol P Cancer development based on chronic active gastritis and resulting gastric atrophy as assessed by serum levels of pepsinogen and Helicobacter pylori antibody titer / T. Yoshida [et al.]. // Int. J. Cancer Vol. 134, 6. - P Correa, P. Gastric cancer: overview. Gastroenterol. / P. Correa // Clin. North Vol. 42, 2. - P

31 36 Agreus, L. Rationale in diagnosis and screening of atrophic gastritis with stomach specific plasma biomarkers/ L. Agreus [et al.]. // Scand. J. Gastroenterol Vol. 47, 2. P De Vries, A.C. Gastric cancer risk in patients with premalignant gastric lesions: a nationwide cohort study in the Netherlands/ De Vries A.C. [et al.]. // Gastroenterology Vol. 134, 4. - P Di Mario, F. Usefulness of serum pepsinogens in Helicobacter pylori chronic gastritis: relationship with inflammation, activity, and density of the bacterium/ Di Mario F. [et al.]. // Dig. Dis. Sci Vol. 51, P Graham, D.Y. Eradication of gastric cancer and more efficient gastric cancer surveillance in Japan: two peas in a pod / D.Y. Graham, M. Asaka [et al.]. // J. Gastroenterol Vol. 45, 1. - P Wong, B.C. Helicobacter pylori eradication to prevent gastric cancer in a high-risk region of China: a randomized controlled trial / Wong B.C. [et al.]. // JAMA Vol. 291, 2. - P

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