Tsang K W, Lam S K, Lam W K, Karlberg J, Wong B C, Hu W H, Yew W W, Ip M S
University Departments of Medicine and Paediatrics, University of Hong Kong, Queen Mary Hospital; and Tuberculosis and Chest Unit, Grantham Hospital, Hong Kong.
Am J Respir Crit Care Med. 1998 Oct;158(4):1047-51. doi: 10.1164/ajrccm.158.4.9712104.
Helicobacter pylori causes chronic inflammation of the gastric mucosa and has been identified in tracheobronchial secretions. Serum IgG against H. pylori was therefore measured prospectively in consecutive subjects with bronchiectasis (n = 100; mean age +/- SD 55.1 +/- 16.7 yr), active pulmonary tuberculosis (n = 87; age, 57.3 +/- 19.1 yr), and healthy volunteers (n = 94; age, 54.6 +/- 7.6 yr). Seropositivity was found in 76.0% of bronchiectatic subjects, which was significantly higher than that of the control (54.3%, p = 0.001) and tuberculous (52.9%, p = 0.0001) groups. Multiple logistic regression, adjusted for age, sex, occupational social class, and number of persons living in the household, showed that H. pylori IgG levels of the bronchiectatic group were still significantly higher than that of the control (p = 0.0014) and tuberculous (p = 0.0154) groups. Multiple regression analysis revealed associations between H. pylori serology and sputum volume (p = 0.03) and age (p = 0.001) in the bronchiectatic patients, but not lung function indices or causes of bronchiectasis. The H. pylori seroprevalence in bronchiectasis was significantly (p = 0.0002) higher in patients who produced more (83.1%) than those who produced less than 5 ml sputum/24 h (58.6%). This is the first report of a high H. pylori seroprevalence in bronchiectasis which appears to be specific. Further studies are indicated to evaluate the possible pathogenic role of H. pylori in bronchiectasis.
幽门螺杆菌可导致胃黏膜慢性炎症,并且已在气管支气管分泌物中被检测到。因此,对连续性支气管扩张患者(n = 100;平均年龄±标准差55.1±16.7岁)、活动性肺结核患者(n = 87;年龄57.3±19.1岁)及健康志愿者(n = 94;年龄54.6±7.6岁)前瞻性地检测了抗幽门螺杆菌血清IgG。支气管扩张患者中76.0%呈血清学阳性,显著高于对照组(54.3%,p = 0.001)和结核组(52.9%,p = 0.0001)。经年龄、性别、职业社会阶层及家庭居住人数校正的多因素logistic回归分析显示,支气管扩张组的幽门螺杆菌IgG水平仍显著高于对照组(p = 0.0014)和结核组(p = 0.0154)。多因素回归分析显示,支气管扩张患者中幽门螺杆菌血清学与痰量(p = 0.03)及年龄(p = 0.001)相关,但与肺功能指标或支气管扩张病因无关。支气管扩张患者中,24小时痰量超过5 ml者的幽门螺杆菌血清阳性率(83.1%)显著高于痰量少于5 ml者(58.6%)(p = 0.0002)。这是关于支气管扩张患者中幽门螺杆菌高血清阳性率的首篇报道,且该阳性率似乎具有特异性。有必要开展进一步研究以评估幽门螺杆菌在支气管扩张中可能的致病作用。