口腔幽门螺杆菌感染与胃幽门螺杆菌感染的相关性探讨

目的 分析口腔和胃幽门螺杆菌(Hp)感染的检测结果,探讨口腔Hp感染与胃Hp感染的相关性,及口腔Hp感染对Hp根除治疗的影响.方法 采用唾液测定螺旋杆菌抗原技术(HPS)和13C/14C尿素呼气试验(UBT)同步检测的方法,对114例有上消化道症状的初诊患者(第1组),129例确诊为胃Hp感染经根除治疗后4周复查的患者(第2组)和33例无消化道症状的健康志愿者(第3组),进行口腔和胃Hp检测.结果 第1组、第2组和第3组HPS阳性检出率分别为77.19%、75.97%和81.82%,3组比较差异无统计学意义(χ2=0.47,P值均>0.05);UBT阳性检出率第1组(52.63%)比第2组(34.11%)和第3组(21.21%)高,第1组与第2组和第3组比较,差异有统计学意义(χ2=8.48和10.19,P均<0.05),第2组与第3组之间差异无统计学意义(χ2=2.03,P>0.05);在UBT阳性者中,HPS阳性检出率差异无统计学意义(3组分别为81.67%、88.64%和100%,χ2=2.25,P值均>0.05).结论 唾液中存在高Hp抗原检出现象,口腔可能是Hp在胃以外的"第二定居地".口服药物治疗对口腔Hp感染几乎无效,口腔Hp的存在可能是胃病发病和复发的一个重要和直接的原因.

Abstract：

Objective To explore association between Helicobacter pylori (Hp) infection in oral cavity and gastric Hp infection through oral cavity and gastric Hp infection testing results analysis, and also to study the effect of Hp infection in oral cavity on Hp eradication treatment. Methods Through Hp saliva test (HPS) and 13C/14C urea breath test (UBT) method, the Hp in oral cavity and stomach were tested in 114 first-visit patients with upper gastrointestinal symptoms (group 1), 129 re-visiting patients who were diagnosed gastric Hp infection with eradication treatment for four weeks (group 2) and 33 volunteers without gastrointestinal symptoms. Results The positive rates of Hp infection by HPS method were 77.19%, 75.97% and 81.82% in group 1, group 2 and group 3 respectively. There was no significant difference between these three groups (χ2=0.47, P>0.05). The positive rate of Hp infection by UBT method in group 1 (52.63%) was higher than those of group 2 (34.11%) and group 3 (21.21%). Compared group 1 with group 2 or group 3, there was significant difference (χ2=8.848, 10.19, P<0.05). There was no significant difference between group 2 and 3 (χ2=2.03, P>0.05). In positive individuals of these three groups tested by UBT method, there was no significant difference of positive rate tested by HPS method (81.67%, 88.64% and 100% of three groups respectively, χ2=2.25, P>0.05). Conclusions The High detection of Hp antigen in saliva indicates that the oral cavity may be the "second settlement" of Hp beside stomach. The oral medicine haslittle effect on oral cavity Hp infection. The existence of oral Hp may be an important and direct factor of incidence and recurrent of gastric diseases.

The study on the association between Helicobacter pylori infection in oral cavity and gastric Helicobacter pylori infection

Objective To explore association between Helicobacter pylori (Hp) infection in oral cavity and gastric Hp infection through oral cavity and gastric Hp infection testing results analysis, and also to study the effect of Hp infection in oral cavity on Hp eradication treatment. Methods Through Hp saliva test (HPS) and 13C/14C urea breath test (UBT) method, the Hp in oral cavity and stomach were tested in 114 first-visit patients with upper gastrointestinal symptoms (group 1), 129 re-visiting patients who were diagnosed gastric Hp infection with eradication treatment for four weeks (group 2) and 33 volunteers without gastrointestinal symptoms. Results The positive rates of Hp infection by HPS method were 77.19%, 75.97% and 81.82% in group 1, group 2 and group 3 respectively. There was no significant difference between these three groups (χ2=0.47, P>0.05). The positive rate of Hp infection by UBT method in group 1 (52.63%) was higher than those of group 2 (34.11%) and group 3 (21.21%). Compared group 1 with group 2 or group 3, there was significant difference (χ2=8.848, 10.19, P<0.05). There was no significant difference between group 2 and 3 (χ2=2.03, P>0.05). In positive individuals of these three groups tested by UBT method, there was no significant difference of positive rate tested by HPS method (81.67%, 88.64% and 100% of three groups respectively, χ2=2.25, P>0.05). Conclusions The High detection of Hp antigen in saliva indicates that the oral cavity may be the "second settlement" of Hp beside stomach. The oral medicine haslittle effect on oral cavity Hp infection. The existence of oral Hp may be an important and direct factor of incidence and recurrent of gastric diseases.