| BackgroundSince Australian scientists Warren and Marshall successfully isolated H. pylori in gastric mucosa from a patient with chronic gastritis for the first time in 1983, there are many studies on H. pylori. Krajden et al first isolated H. pylori in dental plaques from a patient of gastritis in 1989, that indicated oral cavity may be an important reservoir of H. pylori infection in stomach. Ferguson et al first isolated H. pylori in saliva from one patient of gastritis out of nine (1/9,11.1%) in 1993. Since then, many researchers demonstrated detections of H. pylori in the oral cavity. As a result, a large number of them showed that there were H. pylori in dental plaques, paradentium and saliva of patients with diseases such as chronic gastritis and peptic ulcer, and H. pylori in the oral cavity had a similarity with gastric H. pylori in morphology, biochemical characteristics and immune characteristics. An obvious homology was also found in H. pylori from the stomach and from the oral cavity in the same patient when gene-typing was done. Then, studies on the detection of H. pylori in the oral cavity, its relationship with H. pylori in the stomach or its relationship with various kinds of gastric diseases became the investigative hot spots. ObjectiveTo explore the clinical value of the saliva test kit (HPS) in detection of Helicobacter pylori (Hp), and discuss on the influential factors of the rate of the gastric Hp eradiation.Methods1) 120 adult patients with upper digestive tract symptoms underwent all the three methods of detection at the same time:HPS, 14C Urease Breath test (14C-UBT) and gastroscopy.67 health people were selected as the control group, who received above diagnosis of HPS and 14C-UBT.2) 90 patients had chronic gastritis with gastric mucosal erosion diagnosed by gastroscopy and the positive result of 14C-UBT who were treated by triple or quadruple therapy of PPI for 7 days.14C-UBT and HPS were taken 4 weeks later, and the patients were divided into several groups according to the Hp eradiation times in which compared the results of therapeutic treatment.Results1) The positive rates of 14C-UBT in control group and test group were 50.75%, 70.83%, respectively; X2 test suggested that the differences were statistically significant (X2=7.49, P＜0.05). And the positive rates of HPS in the two groups were 53.73%,78.33%, respectively; X2 test also suggested that the differences were statistically significant(X2=12.28, P＜0.05).2) In the 120 cases with upper digestive tract symptoms, for the gastric mucosal tissue staining tested under microscope and 14C-UBT, the positive rates were 66.67%,70.83%, respectively; X2 test suggested that the differences were not statistically significant (X2=0.84, P>0.05). The positive rate of HPS was 78.33%. The difference was statistically significant while it was compared to the rate of the mucosal tissue staining test (X2=4.10, P＜0.05). While compared to the positive rate of 14C-UBT, the difference was not statistically significant yet(X2=1.78, P>0.05).3) Detected by the three methods (gastric mucosal tissue staining test under microscope,14C-UBT and HPS) separately, the positive rates in the peptic ulcer group were all higher than the rates in other groups(the chronic superficial gastritis group, chronic atrophic gastritis group, gastric cancer). But none of them had the statistically significant in difference(X2=2.04,1.92,2.64,P>0.05).4) The positive rate of HPS was 94.12% among 14C-UBT positive, and was 40.0% in patient with 14C-UBT negative, the difference was statistically significant (X2=42.78, P＜0.005).5) In the first, second and third therapy group, the eradiation rates of gastric Hp were 60.0%,46.67%,26.67%, respectively; X2 test suggested that the differences in the three groups were statistically significant (X2=6.84, P＜0.05). The HPS positive rates after treatment in these groups were 56.67%,60.0%,63.33%, respectively; the differences were not statistically significant (X2=0.18, P>0.05).6) The eradiation rate in HPS negative cases was 58.33%, which was obviously higher than that in HPS positive cases(35.19%), the difference was statistically significant (X2=4.69, P＜0.05).ConclusionsThe infection rate of Hp in test group was significantly higher than that in the control group. The positive rate of HPS was higher than that of the mucosal tissue staining test in the cases who visited doctors at first time for their upper digestive symptoms; while it was similar to the positive rate of 14C-UBT. The positive rate of HPS in 14C-UBT positive cases was significantly higher than it in negative cases. These results might suggest that oral cavity is one of the important site besides stomach, and the Hp infection in oral cavity might be closely relevant to the infection in stomach.With the repeat in eradiation of gastric Hp, the recovering rates of Hp decreased gradually. The recovering rate in HPS negative cases was obviously higher than that in positive cases. The eradiation therapy for gastric Hp was nearly inefficiency for oral Hp infection. The drug tolerance of Hp to antibiotics and the oral Hp infection were the key points that influence the effect of gastric Hp eradiation therapy.The perspective of the combined detection by HPS,14C-UBT and gastric mucosal tissue staining test may be worth for further study. The main direction of research should be the synchronic treatment for gastric and oral Hp infection, and the tolerance of Hp to antibiotics. |
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