幽门螺杆菌与克罗恩病：中国单中心回顾性研究。
Helicobacter pylori and Crohn's disease: a retrospective single-center study from China.
机构信息
Department of Gastroenterology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.
出版信息
World J Gastroenterol. 2013 Jul 28;19(28):4576-81. doi: 10.3748/wjg.v19.i28.4576.
AIM
To investigate the association between Helicobacter pylori (H. pylori) infection and the prevalence of Crohn's disease (CD).
METHODS
Subjects were selected from patients admitted the gastrointestinal (GI) department at The First Affiliated Hospital School of Medicine (Zhejiang University) for abdominal pain, hematochezia, diarrhea and other GI symptoms between January 2008 and September 2012. CD was diagnosed by endoscopy and biopsy. H. pylori infection was detected by a (14)C-urea breath test and culturing of the biopsy sample. Demographic, anthropometric and serologic data were collected for each patient. H. pylori infection rate was compared between CD and control groups, followed by a subgroup analysis based on extent and severity of CD. Student's t, Mann-Whiney U, and χ(2) tests were used to analyze the data.
RESULTS
A total of 447 patients were analyzed, including 229 in the CD group and 248 in the control group. There were no significant differences in age, sex, and rates of hypertension or diabetes. However, the CD group showed significantly higher rates of smoking history (34.9% vs 18.1%), alcohol intake (17.4% vs 8.1%), white blood cell count (9.7 ± 2.9 × 10(9)/L vs 4.3 ± 0.9 × 10(9)/L), and C-reactive protein (36.3 ± 20.8 mg/L vs 5.5 ± 2.3 mg/L) but lower body mass index (24.5 ± 2.0 kg/m(2) vs 26.0 ± 2.2 kg/m(2)) than the control group. The H. pylori infection rate in the CD group was 27.1%, significantly lower than that of 47.9% in the control group. Furthermore, the H. pylori infection rates in patients with colonic, small intestine, ileocolonic and extensive CD were 31.1%, 28.9%, 26.8% and 25.9% respectively, all of which were significantly lower than in the control group. Finally, the H. pylori infection rates in patients with remission, moderate and severe CD were 34.3%, 30.7% and 22.0% respectively, which were also significantly lower than in the control group.
CONCLUSION
Lower H. pylori infection in CD patients suggests a correlation between bacterial infection and CD, suggesting caution when considering H. pylori eradication in CD patients.
目的
研究幽门螺杆菌（H. pylori）感染与克罗恩病（CD）患病率之间的关系。
方法
2008 年 1 月至 2012 年 9 月，选取因腹痛、血便、腹泻等胃肠道（GI）症状在浙江大学医学院附属第一医院 GI 科住院的患者作为研究对象。通过内镜和活检诊断 CD，（14）C-尿素呼气试验和活检样本培养检测 H. pylori 感染。收集每位患者的人口统计学、人体测量学和血清学数据。比较 CD 组和对照组的 H. pylori 感染率，然后根据 CD 的范围和严重程度进行亚组分析。采用 Student's t、Mann-Whitney U 和 χ(2)检验进行数据分析。
结果
共分析了 447 例患者，其中 CD 组 229 例，对照组 248 例。两组在年龄、性别、高血压和糖尿病的发生率方面无显著差异。然而，CD 组吸烟史（34.9%比 18.1%）、饮酒史（17.4%比 8.1%）、白细胞计数（9.7±2.9×10(9)/L 比 4.3±0.9×10(9)/L）和 C 反应蛋白（36.3±20.8 mg/L 比 5.5±2.3 mg/L）明显较高，而体重指数（24.5±2.0 kg/m(2) 比 26.0±2.2 kg/m(2））明显较低。CD 组 H. pylori 感染率为 27.1%，明显低于对照组的 47.9%。此外，结肠、小肠、回结肠和广泛性 CD 患者的 H. pylori 感染率分别为 31.1%、28.9%、26.8%和 25.9%，均明显低于对照组。最后，缓解期、中度和重度 CD 患者的 H. pylori 感染率分别为 34.3%、30.7%和 22.0%，也明显低于对照组。
结论
CD 患者 H. pylori 感染率较低提示细菌感染与 CD 之间存在相关性，因此在考虑对 CD 患者进行 H. pylori 根除治疗时需谨慎。
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