De Koster E, De Bruyne I, Langlet P, Deltenre M
Department of Gastroenterology, CHU Brugmann UVC (VUB-ULB), Brussels, Belgium.
Acta Gastroenterol Belg. 2000 Oct-Dec;63(4):388-92.
A putative pathogenetic role has been ascribed to Helicobacter pylori in several extradigestive diseases, including vascular (atherosclerosis and ischaemic heart disease, primary Raynaud phenomenon, primary headache), autoimmune (Sjögren's syndrome, Henoch-Schönlein purpura, autoimmune thyroiditis, idiopathic arrythmias, Parkinson's disease, nonarterial anterior optic ischemic neuropathy), and skin diseases (chronic idiopathic urticaria, rosacea, alopecia areata), sideropenic anemia, growth retardation, late menarche, extragastric MALT lymphoma, diabetes mellitus, hepatic encephalopathy, sudden infant death syndrome, and anorexia of aging. We examine critically the strength of the evidence linking these diseases to Helicobacter pylori, using ischaemic heart disease as an example of epidemiological techniques, and skin diseases as an example of treatment studies. By the standards of evidence-based medicine, studies have been often of low quality. The best evidence usually is not indicative of a role for Helicobacter pylori in these diseases.
幽门螺杆菌在几种消化系统外疾病中被认为具有致病作用，这些疾病包括血管疾病（动脉粥样硬化和缺血性心脏病、原发性雷诺现象、原发性头痛）、自身免疫性疾病（干燥综合征、过敏性紫癜、自身免疫性甲状腺炎、特发性心律失常、帕金森病、非动脉性前部缺血性视神经病变）和皮肤疾病（慢性特发性荨麻疹、玫瑰痤疮、斑秃）、缺铁性贫血、生长发育迟缓、初潮延迟、胃外黏膜相关淋巴组织淋巴瘤、糖尿病、肝性脑病、婴儿猝死综合征以及衰老性厌食症。我们以缺血性心脏病为例，通过流行病学技术，以皮肤疾病为例，通过治疗研究，批判性地审视将这些疾病与幽门螺杆菌联系起来的证据强度。按照循证医学的标准，相关研究质量往往较低。最佳证据通常并不表明幽门螺杆菌在这些疾病中起作用。
