消化不良患者中存在非幽门螺杆菌物种的流行情况。
Prevalence of non Helicobacter pylori species in patients presenting with dyspepsia.
机构信息
Department of Medicine, The Aga Khan University, Karachi, Pakistan.
出版信息
BMC Gastroenterol. 2012 Jan 6;12:3. doi: 10.1186/1471-230X-12-3.
BACKGROUND
Helicobacter species associated with human infection include Helicobacter pylori, Helicobacter heilmannii and Helicobacter felis among others. In this study we determined the prevalence of H. pylori and non-Helicobacter pylori organisms H. felis and H. heilmannii and analyzed the association between coinfection with these organisms and gastric pathology in patients presenting with dyspepsia. Biopsy specimens were obtained from patients with dyspepsia on esophagogastroduodenoscopy (EGD) for rapid urease test, histology and PCR examination for Helicobacter genus specific 16S rDNA, H. pylori phosphoglucosamine mutase (glmM) and urease B (ureB) gene of H. heilmannii and H. felis. Sequencing of PCR products of H. heilmannii and H. felis was done.
RESULTS
Two hundred-fifty patients with dyspepsia were enrolled in the study. The mean age was 39 ± 12 years with males 162(65%). Twenty-six percent (66 out of 250) were exposed to cats or dogs. PCR for Helicobacter genus specific 16S rDNA was positive in 167/250 (67%), H. pylori glmM in 142/250 (57%), H. heilmannii in 17/250 (6%) and H. felis in 10/250 (4%), respectively. All the H. heilmannii and H. felis PCR positive patients were also positive for H. pylori PCR amplification. The occurrence of coinfection of H. pylori and H. heilmannii was 17(6%) and with H. felis was 10(4%), respectively. Only one out of 66 exposed to pets were positive for H. heilmannii and two for H. felis. Histopathology was carried out in 160(64%) of 250 cases. Chronic active inflammation was observed in 53(56%) (p = 0.001) of the patients with H. pylori infection alone as compared to 3(37%) (p = 0.73) coinfected with H. heilmannii and H. pylori and 3(60%) coinfected with H. felis and H. pylori (p = 0.66). Intestinal metaplasia was observed in 3(3%)(p = 1.0) of the patients with H. pylori infection alone as compared to 2(25%) (p = 0.02) coinfected with H. heilmannii and H. pylori and 1(20%) coinfected with H. felis and H. pylori (p = 0.15).
CONCLUSION
The prevalence of H. heilmannii and H. felis was low in our patients with dyspepsia. Exposure to pets did not increase the risk of H. heilmannii or H. felis infection. The coinfection of H. pylori with H. heilmannii was seen associated with intestinal metaplasia, however this need further confirmation.
背景
与人类感染相关的幽门螺杆菌物种包括幽门螺杆菌、幽门螺杆菌和幽门螺杆菌等。在这项研究中，我们确定了幽门螺杆菌和非幽门螺杆菌生物体幽门螺杆菌和幽门螺杆菌的流行率，并分析了这些生物体与消化不良患者胃病理之间的关联。通过快速尿素酶试验、组织学和聚合酶链反应（PCR）检查，从接受胃镜检查（EGD）的消化不良患者中获得活检标本，以检测幽门螺杆菌属特异性 16S rDNA、幽门螺杆菌磷酸葡萄糖胺变位酶（glmM）和幽门螺杆菌尿素酶 B（ureB）基因。对幽门螺杆菌和幽门螺杆菌的 PCR 产物进行测序。
结果
250 例消化不良患者入组本研究。平均年龄为 39 ± 12 岁，男性 162 例（65%）。26%（250 例中有 66 例）接触过猫或狗。250 例患者中，幽门螺杆菌属特异性 16S rDNA 的 PCR 阳性率为 167/250（67%），幽门螺杆菌 glmM 为 142/250（57%），幽门螺杆菌为 17/250（6%），幽门螺杆菌为 10/250（4%）。所有幽门螺杆菌和幽门螺杆菌 PCR 阳性患者的 PCR 扩增也均为阳性。幽门螺杆菌和幽门螺杆菌的合并感染率分别为 17%（6%）和 10%（4%）。仅 1 例接触宠物的患者幽门螺杆菌阳性，2 例幽门螺杆菌阳性。250 例患者中有 160 例（64%）进行了组织病理学检查。与仅感染幽门螺杆菌的 53 例（56%）（p = 0.001）相比，同时感染幽门螺杆菌和幽门螺杆菌的 3 例（37%）（p = 0.73）和同时感染幽门螺杆菌和幽门螺杆菌的 3 例（60%）（p = 0.66）的患者中观察到慢性活动性炎症。仅感染幽门螺杆菌的患者中，肠化生发生率为 3 例（3%）（p = 1.0），而同时感染幽门螺杆菌和幽门螺杆菌的患者为 2 例（25%）（p = 0.02），同时感染幽门螺杆菌和幽门螺杆菌的患者为 1 例（20%）（p = 0.15）。
结论
我们消化不良患者中幽门螺杆菌和幽门螺杆菌的流行率较低。接触宠物不会增加幽门螺杆菌或幽门螺杆菌感染的风险。幽门螺杆菌与幽门螺杆菌的合并感染与肠化生有关，但这需要进一步证实。
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