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消化性溃疡患者的口腔健康状况和口腔卫生习惯以及这些因素如何影响胃内幽门螺杆菌的根除。

Oral health status and oral hygiene practices of patients with peptic ulcer and how these affect Helicobacter pylori eradication from the stomach.

作者信息

Namiot Dorota B, Namiot Zbigniew, Kemona Andrzej, Bucki Robert, Gotebiewska Maria

机构信息

Department of Prosthetic Dentistry, Medical University of Białystok, Białystok, Poland.

出版信息

Helicobacter. 2007 Feb;12(1):63-7. doi: 10.1111/j.1523-5378.2007.00471.x.

Abstract

BACKGROUND

Helicobacter pylori eradication from the oral cavity is more difficult than from the stomach. Thus, if the bacterium survives the antibacterial therapy in the oral cavity, it would be able to re-infect the stomach within a few weeks. Since oral health status could correspond to oral infection with H. pylori, the aim of the study was to determine whether oral health and oral hygiene practices affect the efficacy of H. pylori eradication from the stomach.

MATERIAL AND METHODS

The study was performed in 137 patients with peptic ulcer who had undergone a 7-day course of eradication treatment with one of two sets of drugs: 1, omeprazole, amoxicillin, and tinidazole or 2, omeprazole, clarithromycin, and tinidazole. The efficacy of H. pylori eradication from the stomach was evaluated at the second gastroscopy 4 weeks after cessation of eradication therapy by means of two methods: rapid urease test and histology. The examination of natural dentition and prosthetic restorations as well as the assessment of hygienic procedures referring to natural dentition and dentures accompanied the second gastroscopy.

RESULTS

No association was found between the efficacy of H. pylori eradication from the stomach and the number of natural teeth, decayed teeth, use of dentures, debris index, or periodontal index. However, an association between eradication success and some oral hygiene procedures were noted. Unexpectedly, in patients treated with omeprazole, amoxicillin and tinidazole, the removal of dental prosthesis for the night and brushing the natural teeth twice a day or more reduced the efficacy of H. pylori eradication from the stomach.

CONCLUSIONS

Oral health and oral hygiene practices seem unlikely to increase the efficacy of H. pylori eradication from the stomach.

摘要

背景

从口腔根除幽门螺杆菌比从胃中更难。因此,如果该细菌在口腔抗菌治疗中存活下来,它能够在几周内重新感染胃部。由于口腔健康状况可能与幽门螺杆菌的口腔感染相关,本研究的目的是确定口腔健康和口腔卫生习惯是否会影响从胃中根除幽门螺杆菌的疗效。

材料与方法

该研究纳入了137例消化性溃疡患者,他们接受了为期7天的根除治疗,使用两组药物之一:1. 奥美拉唑、阿莫西林和替硝唑;或2. 奥美拉唑、克拉霉素和替硝唑。在根除治疗停止4周后的第二次胃镜检查时,通过两种方法评估从胃中根除幽门螺杆菌的疗效:快速尿素酶试验和组织学检查。在第二次胃镜检查时,同时检查天然牙列和修复体,并评估针对天然牙列和假牙的卫生程序。

结果

未发现从胃中根除幽门螺杆菌的疗效与天然牙数量、龋齿数量、假牙使用情况、牙菌斑指数或牙周指数之间存在关联。然而,注意到根除成功与一些口腔卫生程序之间存在关联。出乎意料的是,在接受奥美拉唑、阿莫西林和替硝唑治疗的患者中,夜间取下假牙以及每天刷牙两次或更多次会降低从胃中根除幽门螺杆菌的疗效。

结论

口腔健康和口腔卫生习惯似乎不太可能提高从胃中根除幽门螺杆菌的疗效。

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