Blaser M J, Perez-Perez G I, Lindenbaum J, Schneidman D, Van Deventer G, Marin-Sorensen M, Weinstein W M
Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee 37232.
Rev Infect Dis. 1991 Jul-Aug;13 Suppl 8:S704-8. doi: 10.1093/clinids/13.supplement_8.s704.
The association of infection with Helicobacter pylori and antral (type B) gastritis now is clear, and the development of sensitive and specific serologic assays for IgA and IgG allows for diagnosis of this infection by noninvasive means. With use of these assays, we studied the association of infection with H. pylori and four other upper gastrointestinal inflammatory conditions: Barrett's esophagus, pernicious anemia (which accompanies type A gastritis), and duodenal and gastric ulcers. H. pylori was present in only 39% of 41 patients with Barrett's esophagus whose gastric biopsy specimens were examined histologically. Each serologic assay correctly categorized 39 (95.1%) of the 41 patients. For both assays the frequency of seropositivity noted for 58 patients with Barrett's esophagus was not different from that noted for age- and sex-matched healthy controls. Among 40 patients with pernicious anemia, the results of assays for IgA and IgG were positive for 17.5% and 0%, respectively; these prevalences were significantly less than the 50% (IgA) and 40% (IgG) positivities noted for matched controls (P less than .01 for each; McNemar's test). Among 57 patients with documented duodenal or gastric ulcers, the results of assays for IgG and IgA were positive for 100% and 98.2%, respectively; these prevalences were significantly higher than the rate noted for matched controls (P less than .001 for duodenal ulcers and P = .02 for gastric ulcers for IgA assay). These data suggest that infection with H. pylori is strongly associated with duodenal and gastric ulcers, negatively associated with pernicious anemia, and independent of Barrett's esophagus.
幽门螺杆菌感染与胃窦（B型）胃炎之间的关联现已明确，针对IgA和IgG的灵敏且特异的血清学检测方法的开发，使得通过非侵入性手段诊断这种感染成为可能。利用这些检测方法，我们研究了幽门螺杆菌感染与其他四种上消化道炎症性疾病的关联：巴雷特食管、恶性贫血（与A型胃炎相关）以及十二指肠溃疡和胃溃疡。在41例经组织学检查胃活检标本的巴雷特食管患者中，仅39%存在幽门螺杆菌感染。两种血清学检测方法均正确分类了41例患者中的39例（95.1%）。对于这两种检测方法，58例巴雷特食管患者的血清阳性率与年龄和性别匹配的健康对照者的血清阳性率并无差异。在40例恶性贫血患者中，IgA和IgG检测结果的阳性率分别为17.5%和0%；这些患病率显著低于匹配对照者的50%（IgA）和40%（IgG）阳性率（每项P均小于0.01；McNemar检验）。在57例有十二指肠溃疡或胃溃疡记录的患者中，IgG和IgA检测结果的阳性率分别为100%和98.2%；这些患病率显著高于匹配对照者的阳性率（十二指肠溃疡IgA检测P小于0.001，胃溃疡IgA检测P = 0.02）。这些数据表明，幽门螺杆菌感染与十二指肠溃疡和胃溃疡密切相关，与恶性贫血呈负相关，且与巴雷特食管无关。
