NHPH胃炎の感染診断と除菌

Diagnosis and Eradication Therapy of NHPH

要旨●NHPH感染症の診断方法はまだ確立はしておらず，一般臨床で使用できるものは鏡検法に限られている．最近ではヒトの胃生検組織からH. suisの培養に成功し，研究レベルでは感度と特異度の高いPCR検査や抗体検査も開発されている．ただし，ウレアーゼ活性を利用した検査法はNHPH診断には向かない．将来的にはNHPH胃炎の重要性が認識されてくることで，NHPH診断法の製造認可と保険承認がなされると期待している．NHPH感染に対する除菌治療は，H. pyloriの除菌治療と同様に胃酸分泌抑制薬とアモキシシリン，クラリスロマイシン，あるいはメトロニダゾールによる3剤併用1週間療法が有効である．NHPH感染の解明のためには，NHPH感染診断の普及が不可欠である．

　There is now just one approach that can be used in routine clinical practice to diagnose NHPH（Non-Helicobacter pylori Helicobacter）infection, and that is pathological examination. Helicobacter suis was successfully cultured from human gastric biopsy tissue recently. High-sensitivity and specificity polymerase chain reaction tests and antibody tests have also been developed at the research level. However, urease activity-based tests are not appropriate for NHPH diagnosis. In the future, as the significance of NHPH gastritis becomes more widely understood, we anticipate that the NHPH diagnostic method will be given for manufacturing and insurance approval. One-week triple therapy with PPI/P-CAB plus amoxicillin, clarithromycin, or metronidazole is successful for treating NHPH infection and is similar to the treatment for Helicobacter pylori infection. It is crucial to spread diagnostic techniques for NHPH infection to clarify the pathogenesis of the condition.