Abstract：
Helicobacter pylori remains a major health problem worldwide, causing considerable morbidity and mortality due to peptic ulcer disease and gastric cancer. The burden of disease falls disproportionally on less well-resourced populations. As with most infectious diseases, the largest impact on reducing this burden comes from improvement in socioeconomic status, which interrupts transmission. This has been observed in many regions of the world, but the prevalence of infection remains high in many regions where improvements in living standards are slow to occur. Meanwhile, the optimal clinical management and treatment pathways remain unsettled and are evolving with changing antimicrobial resistance patterns. Despite decades of research and clinical practice, major challenges remain. The quest for the most effective, safe, and simple therapy remains the major issue for clinicians. The search for an effective vaccine appears to be elusive still. Clinical guidelines do not infrequently proffer discordant advice. A major challenge for guidelines is for relevance across a variety of populations with a varying spectrum of disease, antimicrobial resistance rates, and vastly different resources. As local factors are central to determining the impact and management strategies for H. pylori infection, it is important that pathways are based on the best available local knowledge rather than solely extrapolating from guidelines formulated in other regions, which may be less applicable. To this end, this revision of the World Gastroenterology Organisation (WGO) H. pylori guideline uses a \"Cascades\" approach that seeks to summarize the principles of management and offer advice for pragmatic, relevant and achievable diagnostic and treatment pathways based on established key treatment principles and using local knowledge and available resources to guide regional practice.
摘要：
幽门螺杆菌仍然是世界范围内的主要健康问题。由于消化性溃疡和胃癌而导致相当高的发病率和死亡率。疾病负担不成比例地落在资源不足的人群身上。和大多数传染病一样，减轻这种负担的最大影响来自社会经济地位的改善，中断传输。这在世界许多地区都有观察到，但是在生活水平改善缓慢的许多地区，感染的患病率仍然很高。同时,最佳临床管理和治疗途径仍未解决,并且随着抗菌素耐药模式的变化而不断发展.尽管几十年的研究和临床实践，重大挑战依然存在。追求最有效的，安全,简单的治疗仍然是临床医生的主要问题。寻找有效疫苗似乎仍然难以捉摸。临床指南并不经常提供不一致的建议。指南的一个主要挑战是在具有不同疾病谱的各种人群中的相关性，抗菌素耐药率，和截然不同的资源。由于当地因素是确定幽门螺杆菌感染的影响和管理策略的核心，重要的是，途径应基于最佳的当地知识，而不是仅仅从其他地区制定的指南中推断出来，这可能不太适用。为此,世界胃肠病学组织（WGO）幽门螺杆菌指南的这次修订使用了“级联”方法，旨在总结管理原则并提供务实的建议，基于既定的关键治疗原则，并利用当地知识和可用资源指导区域实践的相关和可实现的诊断和治疗途径。
