Current Status of Diagnosis, Treatment, and Prevention of Helicobacter pylori Infection in China: A 2024–2025 National Multicenter Cross-Sectional Study

IF 4.6 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Helicobacter Pub Date : 2026-07-06 DOI:10.1111/hel.70151

Zhihao Yin, Zhiqiang Song, Xinlu Ren, Ye Chen, Bin Lv, Hong Lu, Yong Xie, Yiling Li, Xuehong Wang, Chunhui Lan, Ming Lv, Yuan Zhang, Xiaolin Yin, Jun Xia, Liya Zhou

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Abstract

Background

This study aimed to investigate the current knowledge, attitudes, and practices of Chinese physicians regarding the management of Helicobacter pylori infection through a large-scale national survey.

Materials and Methods

This national, multicenter cross-sectional survey was conducted from October 2024 to May 2025 among physicians from over 2200 medical institutions across 31 provinces using an online questionnaire. The survey comprised four dimensions: basic information, knowledge, attitudes, and practices. Results were compared with the Sixth Chinese National Consensus Report on the Management of H. pylori infection and the Maastricht VI/Florence guidelines. Further, subgroup analyzes were conducted.

Results

A total of 6030 valid responses were included. Knowledge: Only 27.5% of participants correctly estimated the H. pylori infection rate as 40%–50%, and 13.5% accurately understood the reinfection rate as 2%. Attitude: Overall, 93.4% of participants reported familiarity with Chinese H. pylori guidelines and consensus statements, and 84.1% supported replacing proton pump inhibitors with potassium-competitive acid blockers. Practice: Gaps were observed in recognizing indications for H. pylori eradication, including unexplained iron deficiency anemia (43.9%), primary immune thrombocytopenia (39.6%), vitamin B12 deficiency (32.3%), and H. pylori infection without countervailing factors (36.8%). The bismuth-based quadruple regimen was the most commonly selected first-line treatment (86.7%); however, 74.5% still selected the amoxicillin + clarithromycin combination, despite the high resistance rate associated with clarithromycin. The dual regimen is gradually gaining acceptance (53.9%). Subgroup analyzes: Greater adherence to guideline recommendations was observed among physicians from higher-level medical institutions, gastroenterologists, those with more years of practice, higher professional titles, and educational levels, as well as those practicing in economically developed regions.

Conclusion

Chinese physicians generally follow guideline-recommended core practices for the diagnosis and treatment of H. pylori. However, notable gaps persist in understanding reinfection rates, identifying appropriate eradication indications, and selecting optimal treatment regimens. Therefore, strengthened educational interventions are warranted.

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中国幽门螺杆菌感染的诊断、治疗和预防现状：2024-2025年全国多中心横断面研究

背景：本研究旨在通过一项大规模的全国调查，了解目前我国医生对幽门螺杆菌感染管理的知识、态度和做法。材料与方法：本研究于2024年10月至2025年5月对31个省2200多家医疗机构的医生进行了全国性、多中心的横断面调查。该调查包括四个方面：基本信息、知识、态度和实践。结果与第六次中国幽门螺旋杆菌感染管理全国共识报告和马斯特里赫特VI/佛罗伦萨指南进行比较。进一步进行亚组分析。结果：共纳入有效问卷6030份。知识：只有27.5%的参与者正确估计幽门螺杆菌感染率为40%-50%，13.5%的参与者准确估计再感染率为2%。态度：总体而言，93.4%的参与者报告熟悉中国幽门螺杆菌指南和共识声明，84.1%的参与者支持用钾竞争性酸阻滞剂替代质子泵抑制剂。实践：在识别根除幽门螺杆菌的适应症方面存在差距，包括不明原因缺铁性贫血（43.9%）、原发性免疫性血小板减少症（39.6%）、维生素B12缺乏症（32.3%）和无补偿因素的幽门螺杆菌感染（36.8%）。以铋为基础的四联治疗方案是最常选择的一线治疗方案（86.7%）；尽管克拉霉素耐药率较高，但仍有74.5%的患者选择阿莫西林+克拉霉素联合用药。双疗法逐渐被接受（53.9%）。亚组分析：在高水平医疗机构的医生、胃肠病学家、执业年限更长、职称更高、教育水平更高的医生以及在经济发达地区执业的医生中，对指南建议的依从性更高。结论：中国医生一般遵循指南推荐的诊断和治疗幽门螺杆菌的核心做法。然而，在了解再感染率、确定适当的根除适应症和选择最佳治疗方案方面仍存在显著差距。因此，加强教育干预是必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Helicobacter 医学-微生物学

CiteScore

8.40

自引率

9.10%

发文量

审稿时长

2 months

期刊介绍： Helicobacter is edited by Professor David Y Graham. The editorial and peer review process is an independent process. Whenever there is a conflict of interest, the editor and editorial board will declare their interests and affiliations. Helicobacter recognises the critical role that has been established for Helicobacter pylori in peptic ulcer, gastric adenocarcinoma, and primary gastric lymphoma. As new helicobacter species are now regularly being discovered, Helicobacter covers the entire range of helicobacter research, increasing communication among the fields of gastroenterology; microbiology; vaccine development; laboratory animal science.