Department of Medical Gastroenterology, Køge University Hospital, Køge, Denmark.
Department of Medical Gastroenterology, Køge University Hospital, Køge, Denmark; Department of Clinical Microbiology, Hvidovre University Hospital, Hvidovre, Denmark.
Clin Gastroenterol Hepatol. 2015 Mar;13(3):507-513.e2. doi: 10.1016/j.cgh.2014.07.065. Epub 2014 Sep 16.
BACKGROUND & AIMS: The parasites Dientamoeba fragilis and Blastocystis have been detected in feces from patients with irritable bowel syndrome (IBS), therefore these parasites may be involved in IBS pathogenesis. We proposed that a higher prevalence of the parasites in IBS subjects compared with asymptomatic controls would support such a mechanism. We aimed to determine the prevalence of these parasites in IBS subjects (cases) and controls and to identify risk factors associated with parasite carriage. METHODS: We performed a population-based, case-control study of an adult population from an internet-based research institute in Denmark. In January 2010, subjects completed a questionnaire based on the Rome III criteria for IBS and answered questions on factors associated with parasite carriage. Respondents (n = 483) were asked to submit fecal samples for parasite testing; samples were analyzed from 124 cases and 204 controls. RESULTS: A greater proportion of controls than cases carried the parasites (50% vs 36%; P = .01). D fragilis was detected in a greater proportion of fecal samples from controls than cases (35% vs 23%; P = .03), as was Blastocystis (22% of controls vs 15% of cases; P = .09), and a greater percentage of controls carried more than 1 species of parasite (16% of controls vs 8% of cases; P = .05). D fragilis infection was associated with having children 5 to 18 years old in the household and Blastocystis infection was associated with high income (≥600,000 Danish Kroner/y, approximately $100,000 US dollars/y), no animals in the household, and drinking bottled water. CONCLUSIONS: D fragilis and Blastocystis were detected in a greater proportion of fecal samples from the asymptomatic background population in Denmark than from subjects with IBS symptoms. These findings indicate that these parasites are not likely to have a direct role in the pathogenesis of IBS. Longitudinal studies are required to understand their role in gastrointestinal health.
背景与目的:脆弱双核阿米巴原虫和肠内寄生虫在肠易激综合征(IBS)患者的粪便中被检测到,因此这些寄生虫可能参与了 IBS 的发病机制。我们假设与无症状对照者相比,IBS 患者中这些寄生虫的患病率更高,这将支持这种机制。本研究旨在确定这些寄生虫在 IBS 患者(病例)和对照者中的流行率,并确定与寄生虫携带相关的危险因素。
方法:我们进行了一项基于人群的病例对照研究,对象为丹麦一个互联网研究机构的成年人群。2010 年 1 月,受试者根据罗马 III 标准完成了 IBS 问卷,并回答了与寄生虫携带相关的因素问题。调查对象(n=483)被要求提交粪便样本进行寄生虫检测;对 124 例病例和 204 例对照者的样本进行了分析。
结果:对照组携带寄生虫的比例大于病例组(50%比 36%;P=0.01)。在对照组中,脆弱双核阿米巴原虫的检出率大于病例组(35%比 23%;P=0.03),肠内寄生虫的检出率也大于病例组(22%比 15%;P=0.09),并且对照组携带一种以上寄生虫的比例大于病例组(16%比 8%;P=0.05)。家庭中有 5 至 18 岁儿童与脆弱双核阿米巴原虫感染相关,高收入(≥600,000 丹麦克朗/年,约 100,000 美元/年)、家庭中无动物和饮用瓶装水与肠内寄生虫感染相关。
结论:在丹麦无症状背景人群的粪便样本中,脆弱双核阿米巴原虫和肠内寄生虫的检出率大于 IBS 症状患者。这些发现表明这些寄生虫不太可能直接参与 IBS 的发病机制。需要进行纵向研究以了解其在胃肠道健康中的作用。
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