Parente F, Maconi G, Sangaletti O, Minguzzi M, Vago L, Rossi E, Bianchi Porro G
Departments of Gastroenterology, L. Sacco University Hospital, Milan, Italy.
Gut. 1996 Nov;39(5):629-33. doi: 10.1136/gut.39.5.629.
To date, very few studies have evaluated the risk of infection among spouses of Helicobacter pylori positive patients and their results are conflicting.
To assess the seroprevalence of H pylori infection in spouse of H pylori positive patients with duodenal ulcer as compared with age and sex matched volunteer blood donors, as well as the frequency of endoscopic gastroduodenal lesions in these spouses, according to the presence or absence of gastrointestinal complaints.
Some 124 spouses (48% males) of patients with duodenal ulcer consecutively seen over a 10 month period were studied. They were all screened for serum IgG anti-H pylori antibodies and asked to complete a questionnaire with particular reference to the presence of chronic or recurrent dyspepsia. Upper gastrointestinal tract endoscopy with antral and corpus biopsy specimens taken for histological examination and urease rapid test was offered to all seropositive spouses. Volunteer blood donors (248), living in Milan and matched for age, sex, north-south origins, and socioeconomic status to the cases, were used as controls.
Spouses of patients with duodenal ulcer had a significantly higher seroprevalence of H pylori infection than controls (71% v 58%, p < 0.05); 30 of 88 (34%) H pylori positive spouses complained of dyspeptic symptoms compared with only four of 34 (12%) seronegative spouses (p < 0.02). At endoscopy, H pylori infection was confirmed in 48 of 49 (98%) seropositive spouses. The endoscopic findings in those spouses showed active duodenal ulcer in eight (17%), duodenal scar and cap deformity in two (4%), active gastric ulcer in two (4%), erosive duodenitis in three (6%), antral erosions in two (4%), antral erosions plus duodenitis in one, and peptic oesophagitis in another patient. The prevalence of major endoscopic lesions was significantly higher in symptomatic spouses than in those who had never been symptomatic.
These findings show that being the spouse of an H pylori positive patient with duodenal ulcer may increase the risk of H pylori colonisation and perhaps of peptic ulcer disease, and raises questions as to whether serological screening of cohabiting partners of H pylori positive patients with duodenal ulcer may be indicated.
迄今为止，很少有研究评估幽门螺杆菌阳性患者配偶的感染风险，且研究结果相互矛盾。
评估十二指肠溃疡幽门螺杆菌阳性患者配偶中幽门螺杆菌感染的血清流行率，并与年龄和性别匹配的志愿献血者进行比较，同时根据是否存在胃肠道不适，评估这些配偶中内镜下胃十二指肠病变的发生率。
对在10个月期间连续就诊的十二指肠溃疡患者的124名配偶（48%为男性）进行了研究。对他们进行了血清IgG抗幽门螺杆菌抗体筛查，并要求他们填写一份问卷，特别提及慢性或复发性消化不良的情况。为所有血清阳性的配偶提供了上消化道内镜检查，并取胃窦和胃体活检标本进行组织学检查和尿素酶快速检测。以居住在米兰、年龄、性别、南北籍贯和社会经济地位与病例匹配的248名志愿献血者作为对照。
十二指肠溃疡患者的配偶幽门螺杆菌感染的血清流行率显著高于对照组（71%对58%，p<0.05）；88名幽门螺杆菌阳性配偶中有30名（34%）主诉有消化不良症状，而34名血清阴性配偶中只有4名（12%）有此症状（p<0.02）。内镜检查时，49名血清阳性配偶中有48名（98%）确诊为幽门螺杆菌感染。这些配偶的内镜检查结果显示，8名（17%）有活动性十二指肠溃疡，2名（4%）有十二指肠瘢痕和球部畸形，2名（4%）有活动性胃溃疡，3名（6%）有糜烂性十二指肠炎，2名（4%）有胃窦糜烂，1名有胃窦糜烂加十二指肠炎，另1名患者有消化性食管炎。有症状的配偶中主要内镜病变的发生率显著高于无症状的配偶。
这些研究结果表明，作为十二指肠溃疡幽门螺杆菌阳性患者的配偶可能会增加幽门螺杆菌定植的风险，甚至可能增加消化性溃疡疾病的风险，并引发了对于十二指肠溃疡幽门螺杆菌阳性患者的同居伴侣是否需要进行血清学筛查的疑问。
