Schlemper R J, van der Werf S D, Biemond I, Lamers C B
Department of Internal Medicine, University Hospital Leiden, The Netherlands.
J Gastroenterol Hepatol. 1995 Nov-Dec;10(6):633-8. doi: 10.1111/j.1440-1746.1995.tb01362.x.
In a Dutch working population, the apparent association between dyspeptic symptoms and Helicobacter pylori infection was found to be entirely due to subjects with an ulcer history. In general populations with a much higher prevalence of H. pylori infection and peptic ulcer disease, such as in Japan, the relationship between dyspepsia and H. pylori has yet to be clarified. A questionnaire on ulcer history and dyspeptic symptoms during the preceding 3 month period was obtained from apparently healthy Japanese employees who underwent a periodic medical examination. In addition, serum samples were analysed for anti-H. pylori IgG antibodies. A total of 196 men and 35 women, aged 23-71 years, participated in the study. Seven women (20%) and 49 men (25%) had a diagnosis of peptic ulcer disease. Among 41 subjects with verified duodenal (26) and/or gastric (17) ulcer, 95% were H. pylori positive while 32% had had frequent dyspeptic symptoms in the 3 months prior to the study (29% of the 35 men and 50% of the 6 women). Among the 147 men and 28 women without an ulcer history, the 3 month period prevalence of frequent dyspepsia was 14 and 32%, respectively. The rate of H. pylori positivity was 80% in non-ulcer dyspeptics and 68% in all other non-ulcer subjects (95% confidence intervals: 61-92 and 61-76%, respectively). Significant differences in symptoms between H. pylori positive and negative subjects could not be detected, neither in the whole population nor in the non-ulcer group. In conclusion, in this Japanese working population, no association was found between dyspeptic symptoms and H. pylori infection, irrespective of the inclusion of subjects with a peptic ulcer history.
在荷兰的工作人群中，消化不良症状与幽门螺杆菌感染之间明显的关联被发现完全是由于有溃疡病史的受试者。在幽门螺杆菌感染和消化性溃疡病患病率高得多的一般人群中，如在日本，消化不良与幽门螺杆菌之间的关系尚未阐明。对接受定期体检的看似健康的日本员工进行了一项关于溃疡病史和前3个月期间消化不良症状的问卷调查。此外，对血清样本进行了抗幽门螺杆菌IgG抗体分析。共有196名男性和35名女性，年龄在23至71岁之间，参与了这项研究。7名女性（20%）和49名男性（25%）被诊断为消化性溃疡病。在41名经证实患有十二指肠溃疡（26例）和/或胃溃疡（17例）的受试者中，95%的人幽门螺杆菌呈阳性，而32%的人在研究前3个月有频繁的消化不良症状（35名男性中的29%和6名女性中的50%）。在147名无溃疡病史的男性和28名无溃疡病史的女性中，频繁消化不良的3个月患病率分别为14%和32%。非溃疡性消化不良患者中幽门螺杆菌阳性率为80%，所有其他非溃疡受试者中为68%（95%置信区间：分别为61 - 92%和61 - 76%）。在幽门螺杆菌阳性和阴性受试者之间，无论是在总体人群还是在非溃疡组中，均未检测到症状上的显著差异。总之，在这个日本工作人群中，无论是否纳入有消化性溃疡病史的受试者，均未发现消化不良症状与幽门螺杆菌感染之间存在关联。
