Miyaji H, Azuma T, Ito S, Abe Y, Gejyo F, Hashimoto N, Sugimoto H, Suto H, Ito Y, Yamazaki Y, Kohli Y, Kuriyama M
Second Department of Internal Medicine, Fukui Medical University, Yoshida-gun, Japan.
J Gastroenterol Hepatol. 2000 Mar;15(3):257-62. doi: 10.1046/j.1440-1746.2000.02070.x.
The manner in which Helicobacter pylori is transmitted is of fundamental importance when considering strategies for its control, yet, to date, the exact mode of transmission remains uncertain.
The seroprevalence of H. pylori in a relatively isolated rural town in Japan (A-town) was examined to analyse the H. pylori infection route. The immunoglobulin G antibodies against H. pylori in 1684 subjects who had received public health examinations in A-town were determined with an enzyme-linked immunosorbent assay. The seroprevalence was compared in five areas according to the water source. The possibility and frequency of intrafamilial infection was analysed by comparing the seroprevalence among family members residing in the same home.
The seroprevalence of H. pylori did not differ significantly between the five areas examined. Seropositivity was significantly more common in the children whose mothers were seropositive (45.0%, 27/60) than in the children whose mothers were seronegative (10.0%, 2/20; odds ratio (OR) = 7.36, P = 0.0036, 95% confidence interval (CI) = 1.57-34.59). Seropositivity was significantly more common in the children whose older siblings were seropositive (55.0%, 22/40) than in the children whose older siblings were seronegative (23.5%, 20/85; OR = 3.97, P = 0.00051, 95% CI = 1.79-8.84). There was no significant relationship in seroprevalence between children and fathers, grandchildren and grandfathers, grandchildren and grandmothers, or within couples. Seropositivity was significantly more common in the adolescents who had attended a nursery school (44.4%, 20/45) than in the adolescents who had not attended a nursery school (25.6%, 109/426) (OR = 2.33, P = 0.0070, 95% CI = 1.24-4.36).
The acquisition of H. pylori infection occurs by close contact with infected individuals in early childhood, especially via contact with infected mothers and other infected children.
在考虑幽门螺杆菌的控制策略时，其传播方式至关重要，但迄今为止，确切的传播模式仍不确定。
对日本一个相对孤立的农村小镇（A镇）的幽门螺杆菌血清流行率进行检测，以分析幽门螺杆菌的感染途径。采用酶联免疫吸附试验测定了在A镇接受公共卫生检查的1684名受试者中抗幽门螺杆菌的免疫球蛋白G抗体。根据水源将五个区域的血清流行率进行比较。通过比较居住在同一家庭中的家庭成员之间的血清流行率，分析家庭内感染的可能性和频率。
所检测的五个区域之间幽门螺杆菌的血清流行率无显著差异。母亲血清阳性的儿童中血清阳性率（45.0%，27/60）显著高于母亲血清阴性的儿童（10.0%，2/20；优势比（OR）=7.36，P = 0.0036，95%置信区间（CI）=1.57 - 34.59）。年长兄弟姐妹血清阳性的儿童中血清阳性率（55.0%，22/40）显著高于年长兄弟姐妹血清阴性的儿童（23.5%，20/85；OR = 3.97，P = 0.00051，95% CI = 1.79 - 8.84）。儿童与父亲、孙辈与祖父、孙辈与祖母或夫妻之间的血清流行率无显著关系。上过幼儿园的青少年中血清阳性率（44.4%，20/45）显著高于未上过幼儿园的青少年（25.6%，109/426）（OR = 2.33，P = 0.0070，95% CI = 1.24 - 4.36）。
幽门螺杆菌感染是在儿童早期通过与受感染个体密切接触而发生的，尤其是通过与受感染的母亲和其他受感染儿童接触。
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