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幽门螺杆菌感染与溃疡性结肠炎的关系——来自中国的病例对照研究。

Association between Helicobacter Pylori infection and ulcerative colitis--a case control study from China.

机构信息

Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, P.R. China.

出版信息

Int J Med Sci. 2013 Aug 30;10(11):1479-84. doi: 10.7150/ijms.6934. eCollection 2013.

Abstract

AIMS

To investigate the association between H. pylori infection and UC prevalence in China.

MATERIALS AND METHODS

Subjects were selected from patients admitted in Department of Gastroenterology for abdominal pain, hematochezia, diarrhea and other GI symptoms during 2009-2012. UC diagnosis was based on both colonoscopy and biopsy. H. pylori detection was based on (14)C urea breath test (UBT) and biopsy sample culture. Patients' demographic, anthropometric and serologic data were selected. H. pylori infection rate was compared between UC and control groups, followed by a subgroup analysis on the association between H. pylori infection and extent and severity degree of UC.

RESULTS

Totally, 153 and 121 patients were selected and divided into UC and control groups. There were no significant differences in age, gender, BMI, hypertension and diabetes. However, smoking history was significantly lower while WBC and CRP levels were significantly higher in UC group. The H. pylori infection rate in UC group was 30.5%, significantly lower than that of 57.0% in control group. The H. pylori infection rate in UC of left colon and whole colon were 33,9% and 24.2% (p<0.05 between them), both significantly lower than that in control group. In addition, the H. pylori infection rates in mild, moderate and severe UC subgroups were 37.8%, 32.3% and 22.2% (p>0.05 among them), all of which were significantly lower than that in control group.

CONCLUSION

We reported a significantly lower H. pylori infection rate in UC patients with different extent and severity degree, which provides evidence for bacteria involvement in UC pathogenesis and reminder clinicians to keep cautious in considering H. pylori eradication in UC patients.

摘要

目的

研究中国幽门螺杆菌(H. pylori)感染与溃疡性结肠炎(UC)患病率之间的关联。

材料和方法

选取 2009-2012 年期间因腹痛、血便、腹泻等胃肠道症状在消化内科住院的患者作为研究对象。根据结肠镜和活检结果诊断 UC,采用(14)C 尿素呼气试验(UBT)和活检样本培养来检测 H. pylori。选择患者的人口统计学、人体测量学和血清学数据。比较 UC 组和对照组之间的 H. pylori 感染率,然后对 H. pylori 感染与 UC 严重程度和范围的关系进行亚组分析。

结果

共纳入 153 例 UC 患者和 121 例对照患者,两组在年龄、性别、BMI、高血压和糖尿病方面无显著差异,但 UC 组吸烟史较低,白细胞计数和 C 反应蛋白水平较高。UC 组 H. pylori 感染率为 30.5%,显著低于对照组的 57.0%。左半结肠和全结肠 UC 患者的 H. pylori 感染率分别为 33.9%和 24.2%(两者之间存在显著差异),均显著低于对照组。此外,轻度、中度和重度 UC 患者的 H. pylori 感染率分别为 37.8%、32.3%和 22.2%(组间差异无统计学意义),均显著低于对照组。

结论

我们报告了不同严重程度和范围的 UC 患者 H. pylori 感染率显著降低,为细菌参与 UC 发病机制提供了证据,并提醒临床医生在考虑 UC 患者是否根除 H. pylori 时应保持谨慎。

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