慢性牙周炎患者口腔幽门螺杆菌对胃幽门螺杆菌感染复发率的影响

Relationship between oral positive Helicobacter pylori(Hp) and recurrent gastric Hp infection in patients with chronic periodontitis

目的探讨慢性牙周炎患者口腔幽门螺杆菌(Hp)对胃Hp感染复发率的影响。方法选择140例有腹部不适症状、并经全口牙周检查有不同程度慢性牙周炎的患者进行胃镜检查,每例患者均取口腔唾液标本进行口腔Hp检测。对胃Hp感染患者根治后半年分别复查胃Hp的感染状况,胃Hp检测采用^(14)C呼气试验。结果胃Hp阳性慢性牙周炎患者口腔Hp检出率比胃Hp阴性患者高(P<0.05),并与牙周炎的严重程度有一定的关系,重度牙周炎患者口腔Hp检出率比轻度牙周炎患者高,差异有统计学意义(P<0.05)。94例胃Hp阳性患者经药物治疗后半年进行复查,胃Hp感染复发率口腔Hp阳性者与Hp阴性者的差异有统计学意义(P<0.05)。重度牙周炎患者的胃Hp感染复发率显著高于轻中度牙周炎患者(P<0.05)。结论牙周炎患者口腔Hp与胃Hp感染密切相关,胃Hp的感染复发率受口腔Hp存在的影响;口腔Hp阳性者的胃Hp感染复发率显著高于口腔Hp阴性者,并与牙周炎的严重程度有一定的关系。

Objective To examine the relationship between oral positive Helicobacter pylori （Hp） and the gastric recur- rent Hp infection in patients with chronic periodontitis. Methods One hundred and forty periodontitis patients with gastric symptoms were enrolled in this study. Saliva specimens were collected for detection of Hp in oral cavity and gastroscopy was undertaken for detection Hp in stomach. For gastric Hp positive patients, 14C-urea breath test was performed 6 months after Hp eradication therapy. Results The rate of oral positive Hp in patients with positive gastric Hp infection was higher than that in patients with negative gastric Hp （P〈0.05）. The rate of oral positive Hp was correlated with severity of periodontitis （P〈0.05）. In 94 cases of positive gastric Hp infection, the recurrent rate in patients with positive oral Hp was higher than that with negative o- ral Hp 6 months after eradication therapy （P〈0.05）. Patients with severe periodontitis had higher recurrent rate of gastric Hp in- fection. Conclusion The presence of Hp in oral cavity might be the cause of recurrent gastric Hp infection, particularly in pa- tients with severe periodontitis.