Helicobacter pylori感染症に関する臨床的研究

歯科的観点からの検討

抄録

Helicobacter pylori (H. pylori) is found on the human gastric mucosa, especially associated with the lesions of chronic gastritis and peptic ulcer disease, as an uneven and patchy distribution. It is considered that the H. pylori transfer to the gastric organ through the mouth. However, there are few reports regarding this issue in dentistry. In this study, the prevalence rate of H. pylori was investigated by using bacteriological detection methods and by an immunochemical method of antibodies (IgG, IgA) in the serum and saliva. Thirty-nine patients who were undergone gastric endoscopic examination and biopsy were included in this study. H. pylori was isolated from gastric specimens of 28 patients (71.8%) in the quantitative culture. The polymerase chain reaction (PCR) method was positivei n 30 (76.9%) gastric specimens. The phenol red dye spraying method was positive in 17 of 25 (68.0%) and the rapid urease test was positive in 25 of 37 patients (67.6%).
While the quantitative culture method could not distinguish H. pylori from dental plaque, but the PCR method was positive in 9 of 28 (32.1%) patients. The 13C-urea breath test was positive in 7 of 15 (46.7%) patients, the serological test (IgG) was positive in 22 of 25 (88.0%) patients. In the gingival mucosa of 13 normal subjects, H. pylori was negative by the quantitative culture method, however, the PCR method showed 5 (38.5%) subjects were positive. A survey was conducted on 785 healthy volunteers for identifying positive rate of H. pylori IgG antibodies in relation to age distribution. The elder age group (over 40 years old) had a high infection rate (over 80%), whereas, under 40 years old, the rate was low (40%). H. pylori antibodies of serum and salivary IgG and IgA were measured in 40 patients. Serum IgG was positive in 22 (55.0%) patients, and serum IgA was positive in 28 (70.0%) patients. Salivary IgG was negative, however, salivary IgA was positive in 27 (67.5%) patients.