Diagnosis of Helicobacter Pylori Infection is Associated with Lower Prevalence and Subsequent Incidence of Crohn's Disease
Diagnosis of Helicobacter Pylori Infection is Associated with Lower Prevalence and Subsequent Incidence of Crohn's Disease
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DOI：
10.1093/ecco-jcc/jjv229
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发表时间：
2016-04-01
影响因子：
8
通讯作者：
Dahlerup, Jens F.
中科院分区：
文献类型：
--
作者：
Bartels, Lars E.;Jepsen, Peter;Dahlerup, Jens F.
幽门螺杆菌感染可预防某些慢性炎症性疾病。本研究考察了H.幽门螺杆菌感染及其与胃肠道疾病克罗恩病[CD]、溃疡性结肠炎[UC]和乳糜泻[CeD]患病率的相关性。H. pylori试验，观察H.这是一项在丹麦中部地区进行的历史性队列研究。患者在接受尿素呼气试验（UBT）检测H后从初级卫生保健中心连续入组。pylori，然后随访中位时间为6年。患者的疾病、出生国和性别是从全国行政登记处获得的。我们使用logistic回归分析比较CD、UC和CeD的患病率，使用考克斯回归分析比较CD、UC和CeD的发病率。幽门螺杆菌阳性和H. pylori阴性的患者，调整混杂变量。pylori阳性率高于H.幽门阴性患者（比值比= 0.36 [0.17-0.75]）。H组CD发病率较低。pylori阳性率高于H.随访期间幽门阴性患者（风险比= 0.59 [0.36-0.96]）。在CeD中发现了类似的趋势，但在UC. H中没有发现。pylori感染可能是CD发展的保护性因素。然而，CD的发生率在UBT后仍然降低，并且可能是H。pylori根除;因此，H.幽门螺杆菌状态可能是其他预防CD的因素的标志。
Helicobacter pylori infection may protect against some chronic inflammatory diseases. This study examined H. pylori infection and its association with the prevalence of the gastrointestinal diseases Crohn's disease [CD], ulcerative colitis [UC], and coeliac disease [CeD]. Incident cases in a follow-up period after H. pylori testing were recorded to investigate if protective effects of H. pylori persisted after probable eradication.This was a historical cohort study performed in the Central Denmark Region. Patients were enrolled consecutively from primary health care centres after a urea breath test [UBT] for H. pylori and were then followed for a median of 6 years. The patient's diseases, country of birth, and gender were acquired from nationwide administrative registries. We used logistic regression to compare the prevalences of CD, UC, and CeD and Cox regression to compare the incidences of CD, UC, and CeD between . pylori-positive and H. pylori-negative patients, adjusting for confounding variables.We found a lower prevalence of CD in H. pylori-positive than in H. pylori-negative patients (odds ratio = 0.36 [0.17-0.75]). There were fewer incident cases of CD in H. pylori-positive than H. pylori-negative patients in the follow-up period (hazard ratio = 0.59 [0.36-0.96]). Similar trends were found for CeD but not for UC.H. pylori infection may be a protective factor against the development of CD. However, the incidence of CD is still reduced after UBT and probable H. pylori eradication; thus, H. pylori status may be a marker for other factors that protect against CD.