幽门螺杆菌在口腔中的特征性分布  

Characteristic distribution of Helicobacter pylori in the oral cavity

作　　者：胡文杰[1] 曹采方[1] 孟焕新[1] 张集昌 马大龙[3] 狄春晖[3] 

机构地区：[1]北京大学口腔医学院牙周科,北京100081 [2]北京大学肿瘤医院,北京100089 [3]北京大学人类疾病基因研究中心,北京100083

出　　处：《中国微生态学杂志》2004年第2期93-95,共3页Chinese Journal of Microecology

基　　金：国家自然科学基金项目资助 (3 0 0 0 0 192 )

摘　　要：目的 :研究幽门螺杆菌 (Helicobacterpylori,Hp)在慢性胃炎患者口腔中的分布。 方法 :依据Hp尿素酶C基因和细胞毒素相关基因 (cagA)设计引物建立PCR方法 ,从 32例慢性胃炎患者口腔内多部位采集标本 ,检测和鉴定牙菌斑 (每人采集 6个牙的龈上和龈下菌斑 )、含漱液、舌背黏膜、颊黏膜及腭黏膜表面中的Hp。 结果 :32例患者中有 2 9例 (90 6 % )从口腔内牙菌斑、含漱液、舌背黏膜、颊黏膜及腭黏膜至少一处检测出Hp ,其中 2 8例 (87 5 % )从胃和口腔内同时检出Hp ,口腔内各部位标本中Hp检出率依次为牙菌斑 84 4 % ,口腔含漱液 5 6 2 % ,舌背黏膜 4 3 8% ,颊黏膜 2 8 1% ,腭黏膜 9 4 % ;在 384份牙菌斑中 ,磨牙的牙菌斑Hp的检出率高于前牙 (33 2 %vs 2 1 9% ,P <0 0 1) ;而上下牙的牙菌斑Hp的阳性率差异无显著性 (2 9 7%vs 2 9 2 % ,P >0 0 5 ) ;在PD >4mm的牙周袋 ,菌斑Hp检出率显著高于PD <4mm的袋 (P <0 0 5 ) ,龈下菌班Hp的阳性率显著高于龈上菌斑 (P <0 0 1)。 结论 :口腔多部位存在Hp ,牙菌斑中居多 ,并呈一定的分布规律 ;口腔Hp可能是胃Hp感染的重要来源。Objective:To investigate the prevalence and distribution of H.pylori in the oral cavity of gastritis patients.Methods:Primers based on the urease C and cag A gene sequence of H.pylori was used in a PCR assay to detect H.pylori.Thirty-two patients with chronic gastritis were recruited.12 supra- and subgingival plaque samples were collected,from six teeth in each subject,for PCR assay.Three samples of scrapings from tongue,buccal,palatal mucosa and one sample of mouth washing was also collected from per subject for detection.Results:Twenty-nine(90.6%) of thirty-two patients with gastritis by endoscopes had at least one H.pylori-positive oral sample in each patient.28 patients were infected with H.pylori both in the stomach and oral cavity.Only one patient was found H.pylori in the oral cavity but not in the stomach.The prevalence of H.pylori in oral cavity from dental plaque,mouth washings,tongue scrapings,buccal mucosa scrapings and palatal mucosa scrapings and palatal mucosa scrapings was 84.4%,56.2%,43.8%,28.1%,and 9.4%?Statistical analysis indicated that H.pylori were more frequently identified in dental plaque from molars than that from incisors(33.2% vs 21.9%,P<0.01).However,there was no difference in H.pylori positive rate between plaque samples from maxillary teeth and mandibular teeth(29.7% vs 29.2%,P>0.05),It was found that supra-and sub-gingival H.pylori were more frequently identified at sites with PD≥4 mm than from PD<4 mm (P<0.01). H.pylori positive rate was significantly higher in subgingival plaque than that in supragingival plaque(P< 0.01).Conclusion: H.pylori were present in the oral cavity of gastritis patients with a characteristic distribution,especially frequently colonizing in dental plaque. H.pylori in the oral cavity may be the important cause of H.pylori-related gastric disease.

关 键 词：幽门螺杆菌 口腔 牙菌斑 胃炎 感染 

分 类 号：R378[医药卫生—病原生物学]