牙周基础治疗对胃内幽门螺杆菌根除率的影响  

Effect of initial periodontal therapy on the eradication of gastric Helicobacter pylori

作　　者：侯海玲[1] 孟焕新[2] 胡文杰[2] 杨宗萍[1] 王景文[1] 

机构地区：[1]北京大学第一临床医学院口腔科,100081 [2]北京大学口腔医学院牙周科

出　　处：《实用口腔医学杂志》2002年第3期198-200,共3页Journal of Practical Stomatology

基　　金：国家自然科学基金资助批准号 30 0 0 0 1 92

摘　　要：目的 :分析牙周炎与胃内幽门螺杆菌 (Helicobacterpylori ,Hp)的关系以及牙周基础治疗对胃内幽门螺杆菌根除率的影响。方法 :选择有慢性牙周炎且胃镜活检尿素酶阳性、病理诊断为慢性胃炎、胃或十二指肠溃疡患者91人进行三联药物治疗 ,其中 3 3人还同时进行了牙周基础治疗。三联药物治疗后分析胃内幽门螺杆菌根除率与患者牙周临床指数的关系 ,以及牙周基础治疗对胃内Hp根除率的影响。 结果 :4个位点平均牙周袋深 <4mm组的患者三联药物治疗 4周后及 1年后的Hp根除率明显高于平均袋深≥ 4mm组的患者 (80 %vs5 2 .2 % ,62 .9%vs 3 4.5 % ,P <0 .0 5 )。经过牙周基础治疗的患者 1年后的Hp根除率显著高于未做牙周基础治疗的患者 (63 .6%vs 3 4.5 % ,P <0 .0 5 )。结论 :药物治疗Hp的根除率与患者的牙周状况和口腔卫生状况有关。口腔Hp可能是胃Hp再感染的病原因素 ,因此对胃内Hp感染同时伴有牙周炎的患者在进行三联药物治疗的同时应配合牙周基础治疗。Objective: To investigate whether periodontitis might adversely affect the outcome of eradication of gastric Helicobacter pylori(Hp) . Methods: Ninety one patients with gastric Helicobacter pylori and periodontitis were enrolled. The patients were treated by medicine therapy, meanwhile 33 of them were treated by initial periodontal therapy. After treatment, the effect of initial periodontal therapy on the eradication of gastric( Hp ) was examined with 13 C urea breath test. The correlation between the gastric eradication rate and periodontitis was analyzed. Results: Four weeks and one year after medicine therapy, the eradication rate was singnificantly lower in the patients with PD≥4 mm than in those with PD<4 mm(80% vs 52.2% and 62.9% vs 34.5% respectively, P <0.05). After one year the eradication rate in the subjects with initial periodontal therapy was significantly higher than in those without the initial periodontal therapy(63.6% vs 34.5%, P <0.05). Conclusion: Periodontitis may affect the therapy of gastric Hp eradication .Initial periodontal therapy should be done in patients with periodontitis and gastric Helicobacter pylori .

关 键 词：牙周炎 幽门螺杆菌 根除率 牙科刮治术 甲硝唑 阿美西林 

分 类 号：R781.05[医药卫生—口腔医学]