Nandurkar S, Talley N J, Xia H, Mitchell H, Hazel S, Jones M
Department of Medicine, University of Sydney, New South Wales, Australia.
Arch Intern Med. 1998 Jul 13;158(13):1427-33. doi: 10.1001/archinte.158.13.1427.
The relationship between Helicobacter pylori infection and symptoms remains controversial. We aimed to determine if an association exists between unexplained dyspepsia (pain or discomfort centered in the upper part of the abdomen) and H pylori.
A validated questionnaire was completed by 592 healthy blood donors. Helicobacter pylori serologic values (via enzyme-linked immunosorbent assay), blood group status, and Rh status were measured; 4.9% of subjects who had a history of peptic ulcer disease were excluded from the analyses.
The prevalence of dyspepsia and no ulcer history was 11% (95% confidence interval [CI], 8.6%-13.8%); 15.4% of subjects with dyspepsia had H pylori while 14.6% of subjects without dyspepsia were infected (P=.90). The mean dyspepsia impact scores (combining frequency and severity) in those with and without H pylori were 4.7 and 5.4, respectively (P=.20). The median H pylori optical density values in dyspepsia vs no dyspepsia were not significantly different (P=.30). Independent risk factors for dyspepsia were the use of aspirin (odds ratio [OR], 2.2; 95% CI, 1.3-3.7) and smoking (OR, 2.1; 95% CI, 1.3-3.6) but not age, sex, marital status, educational level, income, or the use of alcohol, coffee, or nonsteroidal anti-inflammatory drugs. Independent risk factors for H pylori were increasing age (OR, 1.8 per decade; 95% CI, 1.5-2.3), male sex (OR, 2.1; 95% CI, 1.3-3.4), and net family income (OR, 1.8; 95% CI, 1.2-3.3).
Dyspepsia in the community is linked to smoking and aspirin use, but not to H pylori infection.
幽门螺杆菌感染与症状之间的关系仍存在争议。我们旨在确定不明原因的消化不良（以上腹部疼痛或不适为中心）与幽门螺杆菌之间是否存在关联。
592名健康献血者完成了一份经过验证的问卷。测量了幽门螺杆菌血清学值（通过酶联免疫吸附测定法）、血型状态和Rh状态；有消化性溃疡病史的4.9%的受试者被排除在分析之外。
消化不良且无溃疡病史的患病率为11%（95%置信区间[CI]，8.6%-13.8%）；15.4%的消化不良受试者感染了幽门螺杆菌，而未患消化不良的受试者中有14.6%被感染（P = 0.90）。感染和未感染幽门螺杆菌者的平均消化不良影响评分（结合频率和严重程度）分别为4.7和5.4（P = 0.20）。消化不良组与无消化不良组的幽门螺杆菌光密度值中位数无显著差异（P = 0.30）。消化不良的独立危险因素是使用阿司匹林（比值比[OR]，2.2；95%CI，1.3 - 3.7）和吸烟（OR，2.1；95%CI，1.3 - 3.6），而非年龄、性别、婚姻状况、教育水平、收入或使用酒精、咖啡或非甾体抗炎药。幽门螺杆菌感染的独立危险因素是年龄增长（每十年OR，1.8；95%CI，1.5 - 2.3）、男性（OR，2.1；95%CI，1.3 - 3.4）和家庭净收入（OR，1.8；95%CI，1.2 - 3.3）。
社区中的消化不良与吸烟和使用阿司匹林有关，但与幽门螺杆菌感染无关。
