荷兰工作人群中的非溃疡性消化不良与幽门螺杆菌。溃疡病史作为一种明显关联的解释。

Nonulcer dyspepsia in a Dutch working population and Helicobacter pylori. Ulcer history as an explanation of an apparent association.

作者信息

Schlemper R J, van der Werf S D, Vandenbroucke J P, Biemond I, Lamers C B

机构信息

Department of Internal Medicine, University Hospital, Leiden, The Netherlands.

出版信息

Arch Intern Med. 1995 Jan 9;155(1):82-7.

PMID:7802524

Abstract

BACKGROUND

There is considerable debate about whether Helicobacter pylori infection is important in causing nonulcer dyspepsia. Many studies assessing this relationship have been performed in selected patient populations and included patients with a history of peptic ulcer. General population-based data with attention to ulcer history are needed to clarify this relationship.

METHODS

A questionnaire on ulcer history and dyspeptic symptoms during the preceding 3-month period was obtained from apparently healthy employees who underwent a periodic medical examination in the Netherlands. In addition, serum samples were analyzed for anti-H pylori IgG antibodies.

RESULTS

A total of 427 men and 73 women, aged 22 to 69 years, participated in the study. None of the women but 27 men (6%) had a previous diagnosis of peptic ulcer. Among 19 unoperated-on men with verified duodenal (17 subjects) and gastric (two subjects) ulcer, 89% were H pylori positive, while 74% had frequent dyspeptic symptoms in the 3 months before the study. Among the 400 men and 73 women without an ulcer history, the 3-month period prevalence of frequent dyspepsia was 13% and 21%, respectively. The rate of H pylori positivity was 25% in subjects with nonulcer dyspepsia and 29% in all others. The H pylori infection rate increased with age and with a lower occupational level but was independent of gender. In the male population, various differences in symptoms between H pylori-positive and H pylori-negative subjects could be detected when the 27 subjects with a history of ulcer were included, whereas these differences disappeared when these subjects were excluded.

CONCLUSIONS

In the Dutch working population, nonulcer dyspepsia is not related to H pylori infection, whereas for duodenal ulcer the relationship is clear. The apparent association between dyspeptic symptoms and H pylori infection is entirely accounted for by subjects with an ulcer history.

摘要

背景

关于幽门螺杆菌感染在导致非溃疡性消化不良中是否重要存在相当大的争议。许多评估这种关系的研究是在特定患者群体中进行的，并且纳入了有消化性溃疡病史的患者。需要基于普通人群且关注溃疡病史的数据来阐明这种关系。

方法

从在荷兰接受定期体检的看似健康的员工中获取一份关于前3个月期间溃疡病史和消化不良症状的问卷。此外，分析血清样本中的抗幽门螺杆菌IgG抗体。

结果

共有427名男性和73名女性，年龄在22至69岁之间，参与了该研究。女性中无人有消化性溃疡既往诊断，但有27名男性（6%）有此诊断。在19名未经手术治疗且确诊为十二指肠溃疡（17例）和胃溃疡（2例）的男性中，89%幽门螺杆菌呈阳性，而74%在研究前3个月有频繁的消化不良症状。在400名无溃疡病史的男性和73名女性中，频繁消化不良的3个月患病率分别为13%和21%。非溃疡性消化不良患者的幽门螺杆菌阳性率为25%，其他所有人的阳性率为29%。幽门螺杆菌感染率随年龄增长和职业水平降低而升高，但与性别无关。在男性人群中，当纳入27名有溃疡病史的受试者时，幽门螺杆菌阳性和阴性受试者之间在症状上存在各种差异，而当排除这些受试者时，这些差异消失。