中国实用儿科杂志

中国实用儿科杂志 ›› 2026, Vol. 41 ›› Issue (1): 9-15.DOI: 10.19538/j.ek2026010603

• 指南解读 • 上一篇    下一篇

儿童和青少年幽门螺杆菌感染管理策略：国际新指南解读及分析

  

  1. 浙江大学医学院附属儿童医院  儿童与青少年健康与疾病国家临床医学研究中心，浙江  杭州  310052
  • 出版日期:2026-01-06 发布日期:2026-02-25
  • 通讯作者: 张晨美，电子信箱：chzcm@zju.edu.cn

Management strategies for Helicobacter pylori infection in children and adolescents： interpretation of international guidelines and guideline analysis

  1. Children’s Hospital，Zhejiang University School of Medicine；National Clinical Research Center for Children and Adolescents’Health and Diseases，Hangzhou  310052，China
  • Online:2026-01-06 Published:2026-02-25

摘要： 随着抗生素耐药性日益严重及幽门螺杆菌（Helicobacter pylori，Hp）感染流行病学变化，2024年欧美地区联合更新并发布了儿童和青少年Hp感染管理指南。文章旨在系统解读新的国际指南关键更新内容，并对比旧版指南及中国专家共识，提出适合我国实践的应对策略。新指南明确否定Hp感染与儿童功能性腹痛的关联，同时指出其在缺铁性贫血、慢性免疫性血小板减少及部分炎症性疾病中可能起作用。诊断方面，建议针对高风险儿童优先开展无创检测，必要时辅以胃镜及分子耐药分析。治疗上，强调根据药敏结果个体化选择四联疗法，尤其适用于耐药率高地区。与之相比，国内共识更关注其在胃癌一级预防中的意义，主张在资源受限时采用经验性含铋方案治疗。

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Abstract: With the increasing prevalence of antibiotic resistance and changes in the epidemiology of Helicobacter pylori（Hp）infection，the 2024 ESPGHAN/NASPGHAN guidelines have been jointly updated and published regarding the management of Hp infection in children and adolescents. This article aims to systematically interpret the key updates in the new international guidelines，compare them with the previous edition and Chinese expert consensus，and propose practical recommendations tailored to the Chinese clinical context. The new guidelines explicitly refute the association between Hp infection and functional abdominal pain in children，while acknowledging its potential role in iron-deficiency anemia，chronic immune thrombocytopenia，and certain inflammatory diseases. For diagnosis，noninvasive testing is recommended for high-risk children，with endoscopy and molecular resistance testing as adjuncts when necessary. In terms of treatment，individualized quadruple therapy guided by antimicrobial susceptibility testing is emphasized，especially in regions with high resistance rates. In contrast，the Chinese consensus focuses more on the role of Hp eradication in the primary prevention of gastric cancer and supports empirical bismuth-containing regimens when diagnostic resources are limited.

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