Nomura A, Stemmermann G N, Chyou P H, Perez-Perez G I, Blaser M J
Kuakini Medical Center, Honolulu, Hawaii.
Ann Intern Med. 1994 Jun 15;120(12):977-81. doi: 10.7326/0003-4819-120-12-199406150-00001.
To determine whether a preexisting Helicobacter pylori infection increases the risk for developing duodenal or gastric ulcer.
A nested case-control study based on a cohort of 5443 Japanese-American men who had a physical examination and a phlebotomy from 1967 to 1970.
All 10 general hospitals on the Hawaiian island of Oahu.
150 patients with gastric ulcer and 65 patients with duodenal ulcer identified in the cohort of study participants after a hospital surveillance period of more than 20 years.
Stored serum specimens from patients and from matched controls were tested for the presence of serum IgG antibody to H. pylori using enzyme-linked immunosorbent assay.
93% of the 150 patients with gastric ulcer and 78% of the matched controls had a positive antibody level for H. pylori-specific IgG, yielding an odds ratio of 3.2 (95% CI, 1.6 to 6.5). For duodenal ulcer, 92% of the 65 patients and 78% of the matched controls had a positive test result, yielding an odds ratio of 4.0 (CI, 1.1 to 14.2). As the level of antibody to H. pylori increased, a statistically significant increase was noted in the risk for gastric and duodenal ulcer. The association with H. pylori infection was statistically significant for both types of ulcer, even when the diagnosis was made 10 or more years after the serum sample had been obtained.
Preexisting H. pylori infection increases the risk for subsequent development of either duodenal or gastric ulcer disease.
确定既往幽门螺杆菌感染是否会增加患十二指肠溃疡或胃溃疡的风险。
一项巢式病例对照研究，基于1967年至1970年期间进行了体格检查和静脉采血的5443名日裔美国男性队列。
夏威夷欧胡岛的所有10家综合医院。
在超过20年的医院监测期后，在研究参与者队列中确定的150例胃溃疡患者和65例十二指肠溃疡患者。
使用酶联免疫吸附测定法检测患者和匹配对照的储存血清标本中幽门螺杆菌血清IgG抗体的存在情况。
150例胃溃疡患者中有93%以及匹配对照中有78%的幽门螺杆菌特异性IgG抗体水平呈阳性，优势比为3.2（95%可信区间，1.6至6.5）。对于十二指肠溃疡，65例患者中有92%以及匹配对照中有78%检测结果呈阳性，优势比为4.0（可信区间，1.1至14.2）。随着幽门螺杆菌抗体水平的升高，胃溃疡和十二指肠溃疡的风险有统计学意义的显著增加。即使在获得血清样本10年或更长时间后做出诊断，幽门螺杆菌感染与两种类型溃疡的关联在统计学上仍具有显著性。
既往幽门螺杆菌感染会增加随后发生十二指肠溃疡或胃溃疡疾病的风险。
