幽门螺杆菌的诊断进展

Research Progress in the Diagnosis of Helicobacter pylori

摘要: 幽门螺杆菌感染是引发慢性胃炎、消化性溃疡甚至胃癌的重要诱因，精准诊断是开展临床治疗与疾病防控的核心环节。本文采用文献综述法，系统梳理2016至2026年国内外相关期刊论文、Meta分析及临床研究文献，从侵入性诊断、非侵入性诊断、内镜相关诊断三大维度归纳幽门螺杆菌各类检测技术的应用现状与诊断效能。文章总结了尿素呼气试验、粪便抗原检测、病理染色、内镜征象评估等方法的优势与适用人群，详细阐释侧向流免疫分析、CRISPR/Cas基因靶向检测等新型技术的检测原理、研发进展与临床转化瓶颈，分析目前临床存在的特殊人群诊断标准不统一、基层检测技术普及滞后、新型快速诊断技术临床转化缓慢等现实问题。在此基础上提出6项具体研究方向，摒弃宏观发展理念，聚焦可落地的科学问题，以期为临床合理选择诊断方式、开展幽门螺杆菌感染规范化诊疗提供理论参考。

Abstract: Helicobacter pylori infection is an important inducement of chronic gastritis, peptic ulcer and even gastric cancer, and accurate diagnosis is the key link for clinical treatment and disease prevention and control. Adopting the literature review method, this paper systematically sorts out relevant domestic and foreign journal papers, meta-analyses and clinical research literature from 2016 to 2026. It summarizes the application status and diagnostic efficacy of various detection technologies for Helicobacter pylori from three dimensions of invasive diagnosis, non-invasive diagnosis and endoscopic-related diagnosis. This paper concludes the advantages and applicable crowds of methods such as urea breath test, stool antigen detection, pathological staining and endoscopic sign evaluation, expounds the detection principle, research progress and clinical transformation bottlenecks of new technologies such as lateral flow immunoassay and CRISPR/Cas gene targeted detection, and analyzes practical problems including inconsistent diagnostic standards for special populations, lagging popularization of grassroots detection technology, and slow clinical transformation of new rapid diagnostic technology. On this basis, 6 specific research directions are proposed to abandon the macroscopic development concepts and focus on implementable scientific issues, so as to provide theoretical reference for clinical rational selection of diagnosis methods and standardized diagnosis and treatment of Helicobacter pylori infection.