Association Between Halitosis and Gastric Helicobacter pylori Infection
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概要
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口臭の原因は,ほとんどが口腔内の舌苔や歯周病に起因し,その主な原因ガスは揮発性硫黄化合物(VSCs)だと言われている.胃内ヘリコバクタピロリ感染も口臭の一因であるとする報告がなされたが,VSCsを定性・定量的に測定した研究はない.この研究の目的は,胃内ヘリコバクタピロリ感染の陽性者群と陰性者群の口臭と舌苔臭を官能試験およびガスクロマトグラフィによるVSCsの測定を用いて比較することである.また,両群の背景因子として,年齢,性別,口臭に関連すると考えられる口腔内パラメーター(歯垢指数,歯肉炎指数,4mm以上の歯周ポケット数,出血歯周ポケット数,視診による舌苔スコア,舌苔重量)を検討した.80名の患者のうち,胃内ヘリコバクタピロリ感染の陽性者は31名(平均44.7歳)で,陰性者は49名(平均33.8歳)であった.年齢は陽性者の方が有意に高かったが,性別比や口腔内パラメーターなどの背景因子には差を認めなかった.口臭の官能試験では,息をとめた状態の口臭に有意差を認め(オッズ比:2.76,95%信頼区間:1.78～3.74),胃内ヘリコバクタピロリ感染の陽性者の方が陰性者に比較して口臭は臭いことが確認された.しかし,息を吐いた状態の口臭および舌苔臭には両群間に差を認めなかった.ガスクロマトグラフイによるVSCsの測定では,メチルメルカプタンに差を認めなかったが,硫化水素とジメチルサルファイドに有意差(p<0.05)を認めた.今後,胃内ヘリコバクタピロリ感染と口臭との関連について,さらに検討が必要である.The aim of the present study was to assess whether oral odour and tongue coating odour in the gastric Helicobacter pylori (H. pylori) positive patients are more severe organoleptically than those of the negative patients. Moreover, this is the first study of halitosis on H. pylori in which qualitative-quantitative measurements were made by gas chromatography (GC). In addition, the backgrounds (age, gender, oral periodontal parameters and tongue coating) were compared between the 31 H. pylori positive and 49 negative patients. The H. pylori positive group was significantly older than the H. pylori negative group. There were no significant differences in gender, periodontal parameters or visual tongue coating assessment between the two groups. The oral odour assessed with patient holding breath by organoleptic measurement, the gastric H. pylori positive patients was more severe than that of the negative patients (Odds ratio: 2.76, 95% CI: 1.78 to 3.74). There were no significant differences in oral odour assessed with patient exhaling breath and tongue coating odour. The levels of H_2S and (CH_3)_2S but not CH_3SH, in oral air measured by GC were significantly higher in the H. pylori positive patients than in the negative patients (p<0.05). Further research confirming the relation between gastric H. pylori infection and halitosis is needed.
- 東京女子医科大学学会の論文
- 2001-12-25
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