口臭与幽门螺杆菌感染的关系--病例对照研究

摘要

Objective To investigate the relationship between halitosis and helicobacter pylori infection in stomach. Methods 226 subjects without periodontal diseases or systematic disease ( except helicobacter pylori infection) were included. Nasal measurement method was used to divide the participants into the halitosis group ( case group) and the non⁃halitosis group ( control group) . Basic in⁃formation such as gender and age and oral health situation was matched between groups with no statistical difference. Halitosis was diag⁃nosed by OS≥2 and VSC≥110 μg/L respectively. Infection of helicobacter pylori was diagnosed by biopsy. Clinical examination ( in⁃cluding malodour test and oral examination) and questionnaire survey were conducted before gastroscopy. SPSS19.0 software package was used to analyze the data. The logistic regression model was used to analyze the relationship between halitosis and helicobacter pylori infection. Results All the subjects were periodontally healthy according to the periodontal index, with 117 in the case group and 109 in the control group. The prevalence of helicobacter pylori infection in halitosis subjects diagnosed by OS≥2 was significantly higher than that in the normal subjects (60.7% vs 22.9%, P<0.01). Logistic regression analysis showed helicobacter pylori infection was the significant variable in the equation, and the adjusted OR was 4.6 ( P<0.05) . When diagnosed by VSC≥110 μg/L, adjusted OR was 9.3. Conclusion Helicobacter pylori infection in stomach may be involved in the presence of halitosis in periodontally healthy subjects. Further large scale sample prospective studies should be done.%目的：运用病例对照研究方法，对有无口臭人群进行检查和分析，探讨胃幽门螺杆菌（ H． pylori）感染与口臭的关系。方法选择无牙周疾病和全身疾病（胃肠道疾病除外）的受试者共226人，以鼻测法将受试者分为口臭组和非口臭组，即病例组和对照组；两组对象的性别、年龄等基本信息和口腔健康状况相互匹配，无显著差异。对上述研究对象进行口气评估（鼻测法、Halimeter检测挥发性硫化物、OralChroma检测3种挥发性硫化物含量）、口腔检查、问卷调查及胃幽门螺杆菌病理检查。使用SPSS19．0软件，对数据进行统计学分析，采用Logistic回归法，统计排除混杂因素后胃幽门螺杆菌与口臭之间的关系。结果共有226人纳入实验，其中病例组117人，对照组109人。病例组中，71人H．pylori感染，占60．7％；对照组25人H．pylori阳性，占22．9％（P＜0．01）。在双因素分析基础上进行Logistic回归结果显示，H．pylori感染的比值比为4．6（P＜0．01）。当以VSC≥110μg／L作为口臭诊断标准时，H．pylori感染在Logistic回归中的比值比为9．3（ P＜0．05）。结论口臭人群的幽门螺杆菌感染率明显高于非口臭人群，提示幽门螺杆菌感染可能为口臭发病的影响因素，但其致病机制仍需进一步研究。幽门螺杆菌感染是否是非口源性口臭产生的病因，还需今后开展大样本的前瞻性研究进行证实。