Department of Microbiology, Peking University Health Science Center, Beijing, China.
J Oral Pathol Med. 2011 Apr;40(4):317-24. doi: 10.1111/j.1600-0714.2011.01006.x. Epub 2011 Feb 5.
Helicobacter pylori have been found in the oral cavity and stomach. This study is to establish whether there might be any associations between isolates of H. pylori in the oral cavity and those in the stomach by meta-analysis.
Studies reporting raw data on the prevalence of H. pylori infection in the oral cavity in gastric H. pylori-positive and H. pylori-negative patients, in patients with gastroesophageal diseases, and in healthy individuals and studies reporting data on the eradication rate in the oral cavity or stomach, published in the English language, were identified through MEDLINE and EMBASE up to May 2010.
The prevalence of H. pylori infection in the oral cavity in gastric H. pylori-positive patients was significantly higher (45.0%) than that in gastric H. pylori-negative patients (23.9%). The pooled odds ration (OR) was 3.61 and the 95% CI was 1.91-6.82 (P < 0.0001). Different diagnostic methods produced different pooled ORs with PCR the highest (OR = 5.11, 95% CI: 2.08-12.54, P = 0.0004) and rapid urease test (RUT) the lowest (OR = 2.00, 95% CI: 0.80-5.00, P = 0.14). The 44.8% (91/203) prevalence of H. pylori infection in the oral cavity in patients with clinical and/or histological gastroesophageal diseases was significantly higher than the 13.2% (21/159) in patients with non-ulcerous dyspepsia or healthy controls (OR = 5.15, 95% CI: 2.97-8.92, P < 0.00001). The eradication efficiency in stomach is 85.8% (187/218), while in oral cavity it is only 5.7% (9/158). The OR is 55.59, P < 0.00001.
There is a close relation between the infection of H. pylori in the oral cavity and stomach. H. pylori in the oral cavity are more difficult to be eradicated than in the stomach. It may be a source of reinfection.
幽门螺杆菌已在口腔和胃部中被发现。本研究通过荟萃分析来确定口腔和胃部的幽门螺杆菌分离株之间是否存在任何关联。
通过 MEDLINE 和 EMBASE 检索了截至 2010 年 5 月发表的英文文献，纳入了报道口腔中幽门螺杆菌感染的流行率（在胃幽门螺杆菌阳性和阴性患者、胃食管疾病患者以及健康个体中）和报道口腔或胃部幽门螺杆菌根除率的研究，并提供了原始数据。
胃幽门螺杆菌阳性患者口腔中幽门螺杆菌感染的流行率（45.0%）明显高于胃幽门螺杆菌阴性患者（23.9%）。合并优势比（OR）为 3.61，95%可信区间（CI）为 1.91-6.82（P<0.0001）。不同的诊断方法产生了不同的合并 OR，其中聚合酶链反应（PCR）最高（OR=5.11，95%CI：2.08-12.54，P=0.0004），快速尿素酶试验（RUT）最低（OR=2.00，95%CI：0.80-5.00，P=0.14）。在有临床和/或组织学胃食管疾病的患者中，口腔中幽门螺杆菌感染的流行率为 44.8%（91/203），明显高于非溃疡性消化不良或健康对照患者的 13.2%（21/159）（OR=5.15，95%CI：2.97-8.92，P<0.00001）。胃内的根除效率为 85.8%（187/218），而口腔内仅为 5.7%（9/158）。OR 为 55.59，P<0.00001。
口腔和胃部的幽门螺杆菌感染之间存在密切关系。口腔中的幽门螺杆菌比胃部更难根除，可能是再感染的来源。
