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研究生:林乃蓁
論文名稱:牙菌斑及胃中幽門螺旋桿菌之探討
指導教授:何坤炎何坤炎引用關係
學位類別:碩士
校院名稱:高雄醫學大學
系所名稱:牙醫學研究所
學門:醫藥衛生學門
學類:牙醫學類
論文種類:學術論文
論文出版年:2003
畢業學年度:91
語文別:中文
論文頁數:64
中文關鍵詞:幽門螺旋桿菌牙菌斑聚合脢鍊鎖反應快速尿素脢測試
相關次數:
  • 被引用被引用:4
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  • 下載下載:46
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目的:幽門螺旋桿菌(Helicobacter pylori)是世界上最常見的病菌之一,與十二指腸潰瘍、胃潰瘍、胃炎關係密切,且會使潰瘍癒合延遲、潰瘍再發,與胃癌的發生也有一定的關係。牙菌斑提供只需少量氧氣即能生長的環境,有利於幽門螺旋桿菌之生長,但口腔是否為其永久的藏身之處還是莫衷一是。本研究的目的在探討胃部及牙菌斑中之幽門螺旋桿菌的關係。
材料與方法:本研究對象為至高雄醫學大學胃腸內科胃鏡檢查之患者152位,排除條件包括曾接受過腸胃道手術、無牙、以及一個月內曾接受藥物治療(包括質子幫浦抑制劑、抗生素、鉍鹽)者。所有患者均接受胃鏡檢查並同時於胃竇及胃體部切片,施行快速尿素酉每測試、細菌培養、組織學檢查及13C尿素呼氣試驗,並以幽門螺旋桿菌培養陽性或其他三項中二項陽性為胃部幽門螺旋桿菌陽性。胃鏡檢查當天收集牙菌斑樣本並記錄患者之牙菌斑指數及牙齦指數,以快速尿素酉每測試及聚合酉每鏈鎖反應檢測cagA基因。這些患者經藥物治療四個月後,再取胃黏膜切片及牙菌斑做同樣的檢測,以確定幽門螺旋桿菌根除治療的結果。
結果:分別以聚合酉每鏈鎖反應及快速尿素酉每測試檢測患者治療前牙菌斑中的狀況,與胃中感染情形之間的odds ratio分別為2.5及2.9,顯示牙菌斑有幽門螺旋桿菌存在確為胃部感染的危險因子之一。在根除治療後,牙菌斑中仍有幽門螺旋桿菌存在,顯示抗生素可能無法如在胃中有效根除牙菌斑中的細菌。胃中幽門螺旋桿菌陽性者之牙齦指數明顯高於陰性者,顯示口腔衛生對胃部的感染與否具有影響。
結論:牙菌斑中有幽門螺旋桿菌的存在,且於根除治療後仍存在牙菌斑中之幽門螺旋桿菌,可能為胃部感染再發的來源之一。
中文摘要…………………………………………………………………1
英文摘要…………………………………………………………………3
第一章 前言……………………………………………………………5
第二章 文獻回顧………………………………………………………7
第一節 細菌簡介、致病因子及致病機轉……………………………7
第二節 傳播模式……………………………………………………11
第三節 危險因子……………………………………………………16
第四節 幽門螺旋桿菌的病理學及治療……………………………17
第三章 材料與方法……………………………………………………20
第一節 受檢對象……………………………………………………20
第二節 研究步驟……………………………………………………21
第三節 主要試劑、材料與儀器設備………………………………26
第四節 資料處理與分析……………………………………………29
第四章 結果……………………………………………………………30
第一節 治療前胃部感染情況之計算………………………………30
第二節 治療前分組之計算…………………………………………33
第三節 幽門螺旋桿菌根除治療後…………………………………36
第五章 討論……………………………………………………………39
第六章 結論……………………………………………………………45
參考文獻………………………………………………………………46
圖一……………………………………………………………………58
圖二……………………………………………………………………58
表一……………………………………………………………………59
表二……………………………………………………………………60
表三……………………………………………………………………61
表四……………………………………………………………………62
表五……………………………………………………………………63
表六……………………………………………………………………64
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