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肠寄生虫病的流行率在肠易激综合征患者中并不更高:一项基于人群的病例对照研究。

The prevalence of intestinal parasites is not greater among individuals with irritable bowel syndrome: a population-based case-control study.

机构信息

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.

出版信息

Clin Gastroenterol Hepatol. 2015 Mar;13(3):507-513.e2. doi: 10.1016/j.cgh.2014.07.065. Epub 2014 Sep 16.


DOI:10.1016/j.cgh.2014.07.065
PMID:25229421
Abstract

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.

摘要

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。

相似文献

[1]
The prevalence of intestinal parasites is not greater among individuals with irritable bowel syndrome: a population-based case-control study.

Clin Gastroenterol Hepatol. 2014-9-16

[2]
Active ulcerative colitis associated with low prevalence of Blastocystis and Dientamoeba fragilis infection.

Scand J Gastroenterol. 2013-5

[3]
Prevalence, incidence, and risk factors of intestinal parasites in Danish primary care patients with irritable bowel syndrome.

Scand J Infect Dis. 2014-3

[4]
[Role of Dientamoeba fragilis and Blastocystis spp. in Irritable Bowel Syndrome].

Turkiye Parazitol Derg. 2013

[5]
Blastocystis hominis and Dientamoeba fragilis in patients fulfilling irritable bowel syndrome criteria.

Parasitol Res. 2010-6-8

[6]
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Eur J Clin Microbiol Infect Dis. 2019-10-28

[7]
The role of Blastocystis sp. and Dientamoeba fragilis in irritable bowel syndrome: a systematic review and meta-analysis.

Parasitol Res. 2017-9

[8]
Irritable bowel syndrome: a review on the role of intestinal protozoa and the importance of their detection and diagnosis.

Int J Parasitol. 2007-1

[9]
Investigation of Dientamoeba fragilis and Blastocystis in patients from Turkey with ulcerative colitis and irritable bowel syndrome: Any relation with genotypes?

Acta Trop. 2022-7

[10]
Blastocystis: unravelling potential risk factors and clinical significance of a common but neglected parasite.

Epidemiol Infect. 2009-11

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