牙周基础治疗在根除胃内幽门螺杆菌中的作用

Influence of initial periodontal therapy on the eradication of gastric Helicobater pylori

目的探讨慢性牙周炎与胃内幽门螺杆菌(Hp)的相关性及牙周基础治疗对胃内Hp根除率的影响。方法选340例上消化道不适的患者行牙周检查和胃镜下快速尿素酶检查,将其按有无慢性牙周炎分为A和B两组,将A组中Hp阳性患者随机分为A1和A2两组,B组中Hp阳性患者为B1。A1和B1组接受标准三联治疗,A2组在标准三联的基础上加牙周基础治疗,治疗后4周和1年后测定各组Hp根除率。结果 A和B组Hp检出率分别为84.8%和56.2%,差异具有统计学意义(χ2=34.01,P<0.05)。治疗后4周后A1、A2和B1组患者Hp根除率分别为68.5%、85.4%和83.6%,其中A1组与A2组、A1组与B1组比较差异均具有统计学意义(χ2=7.13、4.87,P均<0.05)。治疗后1年A1、A2和B组患者Hp根除率分别为40.4%、78.7%和71.2%,其中A1与A2组、A1与B1组相比差异均具有统计学意义(χ2=26.96、15.32,P均<0.05)。结论慢性牙周炎患者胃内Hp检出率增高且影响胃内Hp的根除,牙周基础治疗可以提高胃内Hp根除率。

Objective To study the relationship between chronic periodontitis and gastric Helicobater pylori（Hp） and investigate the influence of initial periodontal therapy on the eradication of gastric Hp. Methods Total of 340 patients with the stomach discomfort who were done periodontal examinationn and rapid urease test were collected, then those patients were divided into A and B groups according to whether had chronic periodontitis. The Hp positive patients in A group were randomly divided into A1 and A2 groups; the patients with Hp positive in B group were named as B1 group. A1 and B1 groups received standard triple therapy, while A2 group received initial periodontal therapy based on standard triple therapy, respectively. Four weeks and 1 years after treatment, the Hp eradication rate were detected, respectively. Results The detection rate of Hp were 84.8% and 56.2% in A and B groups（χ^2 = 34.01, P 〈0.05）. Four weeks after treatment, the Hp eradication rates were 68.5%, 85.4% and 80.1% in A1, A2 and B1 groups, respectively. There were significant difference in A1 vs A2 groups and A1 vs B1 groups（χ^2 = 7.13, 4.87; P all 〈0.05）. One year after treatment, the eradication rates of Hp were 40.4%, 78.7% and 71.2% in A1, A2 and B1 groups, respectively. There were significant difference in A1 vs A2 groups and A1 vs B1 groups（χ^2 = 26.96, 15.32; P all 〈0.05）. Conclusions The detection rate of Hp were higer in patients with chronic periodontitis, and there is effect in eradication of gastric Hp. Initial periodontal treatment could increase the rate of gastric Hp.