Moayyedi P, Forman D, Braunholtz D, Feltbower R, Crocombe W, Liptrott M, Axon A
Centre for Digestive Diseases, The General Infirmary at Leeds, United Kingdom.
Am J Gastroenterol. 2000 Jun;95(6):1448-55. doi: 10.1111/j.1572-0241.2000.2126_1.x.
Upper gastrointestinal disorders are common in the community, yet the determinants of these symptoms are poorly characterized. The association between upper gastrointestinal symptoms and Helicobacter pylori (H. pylori), socioeconomic status, nonsteroidal antiinflammatory drug (NSAID) use, smoking, alcohol, and coffee intake was assessed in a cross-sectional survey.
Subjects between the ages of 40-49 yr were randomly selected from the lists of 36 primary care centers. Participants attended their local primary care center and were interviewed by a researcher using a validated dyspepsia questionnaire. H. pylori status was determined by a nonfasting 13C-urea breath test.
A total of 32,929 subjects were invited, and 8,407 (25%) attended and were eligible. Of these, 2,329 (28%) were H. pylori positive and 3,177 (38%) had dyspepsia. Also, 44% of H. pylori-infected participants reported dyspepsia compared with 36% of uninfected subjects [odds ratio = 1.39; 95% confidence interval (CI) 1.26-1.53]. H. pylori infection remained a significant risk factor for dyspepsia in a multiple logistic regression model (odds ratio = 1.21; 95% CI 1.09-1.34), suggesting that 5% of dyspepsia in the population is attributable to H. pylori. NSAIDs, low educational attainment, renting accommodation, absence of central heating, sharing a bed with siblings, and being married were also significantly associated with dyspepsia in this model. Smoking, but not drinking alcohol or coffee, was marginally associated with dyspepsia, but this finding was not robust. These factors were not associated with any dyspepsia subtype.
H. pylori is significantly associated with dyspepsia and may be responsible for 5% of upper gastrointestinal symptoms in the community.
上消化道疾病在社区中很常见，但这些症状的决定因素却鲜有明确描述。在一项横断面调查中，对上消化道症状与幽门螺杆菌（H. pylori）、社会经济地位、非甾体抗炎药（NSAID）使用、吸烟、饮酒及咖啡摄入量之间的关联进行了评估。
从36个基层医疗中心的名单中随机选取40至49岁的受试者。参与者前往当地基层医疗中心，由一名研究人员使用经过验证的消化不良问卷进行访谈。通过非空腹13C-尿素呼气试验确定幽门螺杆菌感染状况。
共邀请了32,929名受试者，8407人（25%）前来参加且符合条件。其中，2329人（28%）幽门螺杆菌呈阳性，3177人（38%）有消化不良症状。此外，44%的幽门螺杆菌感染参与者报告有消化不良症状，而未感染受试者的这一比例为36%[比值比 = 1.39；95%置信区间（CI）1.26 - 1.53]。在多因素逻辑回归模型中，幽门螺杆菌感染仍是消化不良的一个显著危险因素（比值比 = 1.21；95%CI 1.09 - 1.34），这表明人群中5%的消化不良可归因于幽门螺杆菌。在该模型中，非甾体抗炎药、低教育程度、租房、无中央供暖、与兄弟姐妹同床以及已婚也与消化不良显著相关。吸烟与消化不良有轻微关联，但饮酒和喝咖啡与消化不良无此关联，不过这一发现并不十分可靠。这些因素与任何消化不良亚型均无关联。
幽门螺杆菌与消化不良显著相关，可能导致社区中5%的上消化道症状。
