【摘要】 目的 探讨口腔幽门螺杆菌（Hp）感染与胃Hp感染的相关性,及口腔Hp感染对Hp根除治疗的影响。方法 选择216例上消化道不适患者,均给予幽门螺杆菌唾液测试板（HPS）,¹³C-UBT检测,以¹³C-UBT为金标准,对HPS法检测结果 用贝叶斯定理方法 进行评价。选择¹³C-UBT阳性患者168例,经PPI三联或四联7天疗法规范的抗Hp治疗后4周和3个月,复查¹³C-UBT,并对两者结果 进行对比研究。结果 ①利用贝叶斯定理计算得出:在口腔感染Hp发生的条件下胃感染Hp发生的概率为84.1%。HPS的灵敏度为66.1%,特异度为56.3%,阳性预测值为84.1%,阴性预测值为32.1%。②216例上消化道不适患者中,HPS阳性率为61.1%,¹³C-UBT阳性率为77.8%,两种检测方法 比较,差异有统计学意义（x²=14.138,P<0.01）.¹³C-UBT阳性者,HPS阳性率为66.1%;¹³C-UBT阴性者,HPS阳性率为43.8%,两者比较差异有统计学意义（x²=7.827,P<0.01）。③治疗后4周,HPS阳性者（n=75）,胃Hp根除率为93.3%;HPS阴性者（n=27）,胃Hp根除率为92.6%,两者比较差异无统计学意义（x²=0.000,P>0.05）.3个月后,HPS阴性者（n=42）胃Hp根除率（63.2%）,明显高于HPS阳性者（n=19）（33.3%）,两者比较差异有统计学意义（x²=4.758,P<0.05）)。结论口腔Hp感染与胃内Hp感染密切相关,胃Hp的感染复发率受口腔Hp存在的影响。更多还原

【Abstract】 Objective To explore association between Helicobacter pylori（Hp） infection in oral cavity and gastric Hp infection,and also to study the effect of Hp infection in oral cavity on Hp eradication treatment.Methods A total of 216 patients with dyspepsia went through HPS and ¹³C-UBT examination.As gold standards of ¹³C-UBT,a comparison study with HPS was evaluated using Bayes formula.168 patients had the positive result of ¹³C-UBT who were treated by triple or quadruple therapy of PPI for 7 days.¹³C-UBT was taken 4 weeks and 3 months later after the treatment finished.And the results detected by the two methods above were compared.Results ①Calculated using bayes’ theorem:under the condition of oral helicobacter pylori infection incidence of gastric helicobacter pylori infection was 84.1%.The sensitivity,specificity,positive and negative predictive value of HPS was 66.1%,56.3%,84.l%and 32.1%respectively.②In the 216 patients with dyspepsia.The positive rate of HPS was 61.1%.The difference was statistically significant while it was compared to the rate of ¹³C-UBT（77.8%）（x² =14.138,P<0.01）.The positive rate of HPS was 66.1%among ¹³C-UBT positive,and was 43.8%in patient with ¹³C-UBT negative,the difference was statistically significant（x² = 7.827,P<0.01）.③ 4weeks after the treatment finished,the eradiation rate in HPS positive cases（n = 75） was 93.3%,and negative cases was92.6%（n = 27） and the difference was not statistically significant（x² =0.000,P>0.05）.3 months later,the eradiation rate in HPS negative cases was 63.2%.which was obviously higher than that in HPS positive cases（33.3%）,the difference was statistically significant（x² =4.758,P<0.05）).Conclution The Hp infection in oral cavity might be closely relevant to the infection in stomach.The existence of oral Hp might be the cause of recurrent gastric Hp infection.更多还原