唾液幽门螺杆菌抗原检测与慢性胃炎活动性及癌前病变关系的研究

目的评价唾液幽门螺杆菌(Helicobacterpylori,Hp)抗原与慢性胃炎活动性以及胃黏膜癌前病变肠上皮化生与不典型增生的相关性。方法应用酶联免疫吸附法(ELISA),对2004年6月至2005年6月浙江大学医学院附属第二医院消化内科246例接受胃镜检查患者的唾液标本进行幽门螺杆菌抗原检测,分别比较不同胃病患者唾液中Hp抗原的阳性检出率。结果慢性活动性胃炎组唾液中Hp抗原阳性检出率为74.29%(26/35),明显高于慢性非活动性胃炎组46.92%(99/211)(P<0.05)。慢性胃炎组患者唾液中Hp抗原的阳性检出率为45.98%(80/174),慢性胃炎伴轻度肠上皮化生(肠化)组唾液中Hp抗原阳性检出率为52.63%(20/38),慢性胃炎伴中重度肠化组唾液中Hp抗原阳性检出率为68.18%(15/22),慢性胃炎伴不典型增生组唾液中Hp抗原阳性检出率为83.33%(10/12),结果显示,慢性胃炎伴中重度肠化或不典型增生组与慢性胃炎组相比,差异有统计学意义(P<0.05)。结论唾液中存在高Hp检出率现象,口腔可能为Hp的重要寄居地,口腔内Hp感染程度与胃炎活动程度及部分胃黏膜癌前病变有关,慢性活动性胃炎或伴中重度肠化或不典型增生患者口腔内Hp检出率明显增高,口腔内Hp是否需行根除治疗,值得今后进一步研究探讨。

The relationship between Helicobacter pylori antigen in saliva and the activity of gastritis and precancerous lesios

Objective To evaluate the relationship between Helicobacter pylori antigen in saliva and the activity of gastritis and like intestinal metaplasia(IM)or atypical hyperplasia(AH).Methods From June 2004 to June 2005 Helicobacter pylori antigen were detected in saliva of 246 persons by enzyme-linked immunosorbent assay(ELISA),and the Hp-positive rates in saliva in patients with different gastritis were compared.Results The Hp-positive rate in saliva in patients with active chronic gastritis was 74.29%(26/35),which was significantly higher(P<0.05)than patients with inactive chronic gastritis 46.92%(99/211).The Hp-positive rates in saliva in patients with chronic gastritis,chronic gastritis with light-level IM,chronic gastritis with middle to heavy-level IM and chronic gastritis with AH were 45.98%(80/174),52.63%(20/38),68.18%(15/22)and 83.33%(10/12)respectively,as a result,the Hp-positive rates in saliva in patients with chronic gastritis with middle to heavy-level IM and AH were significantly higer(P<0.05)than patients with chronic gastritis.Conclusion The iigh detection of Hp in saliva indicates that oral cavity maybe another important reservoir of Hp.Hp infected condition in saliva is related to the activity of the gastritis or the precancerous lesions.There is high Hp detection in saliva in patients with active gastritris and chronic gastritis with middle to heavy-level IM and AH.Whether to eradicate the Hp in saliva or not is another problem that should be further studied in the future.