消化不良性肝硬化患者的幽门螺杆菌感染
Helicobacter pylori infection in dyspeptic cirrhotic patients.
作者信息
Zullo A, Rinaldi V, Meddi P, Folino S, Lauria V, Diana F, Winn S, Attili A F
机构信息
Department of Clinical Medicine-Gastroenterology II, University of Rome La Sapienza, Italy.
出版信息
Hepatogastroenterology. 1999 Jan-Feb;46(25):395-400.
BACKGROUND/AIMS: To date, few studies have focused on the role of Helicobacter pylori (H. pylori) in cirrhotic patients with gastroduodenal disease and reported results are conflicting. The aim of this study was to assess the H. pylori infection rate in dyspeptic cirrhotic patients with or without gastroduodenal lesions at endoscopy.
METHODOLOGY
In a prospective study, 226 consecutive dyspeptic cirrhotic patients were enrolled in the study upon assessment of H. pylori infection. Two-hundred dyspeptic non-cirrhotic patients were also included as controls. The presence of H. pylori was detected by rapid urease test and histology (Giemsa staining) in 3 biopsy specimens from the antrum and 3 from the gastric body.
RESULTS
H. pylori infection was found in 135 (59.7%) cirrhotics and in 121 (60.5%) controls (p = NS). The prevalence of gastric ulcer was higher in cirrhotics than in controls (16% vs. 2.5%, p = 0.0001), while the prevalence of duodenal ulcer was similar (11% vs. 12%, respectively). The H. pylori infection rate was similar between cirrhotics and controls, both with gastric (83% vs. 80%) and with duodenal (88% vs. 96%) ulcers. Moreover, in our study, a H. pylori-related peptic lesion was the cause of previous gastroduodenal bleeding in 6 of 50 (12%) cirrhotic patients.
CONCLUSIONS
Our results indicated that H. pylori infection is implicated in the pathogenesis of peptic ulcer in cirrhotic patients, similar to findings in non-cirrhotic patients.
背景/目的:迄今为止,很少有研究关注幽门螺杆菌(H. pylori)在患有胃十二指肠疾病的肝硬化患者中的作用,且报告结果相互矛盾。本研究的目的是评估在内镜检查中有无胃十二指肠病变的消化不良肝硬化患者的幽门螺杆菌感染率。
方法
在一项前瞻性研究中,226例连续的消化不良肝硬化患者在评估幽门螺杆菌感染后纳入研究。另外200例消化不良的非肝硬化患者也作为对照。通过快速尿素酶试验和组织学检查(吉姆萨染色)在取自胃窦的3份活检标本和取自胃体的3份活检标本中检测幽门螺杆菌的存在。
结果
135例(59.7%)肝硬化患者和121例(60.5%)对照者发现幽门螺杆菌感染(p=无显著性差异)。肝硬化患者胃溃疡的患病率高于对照组(16%对2.5%,p=0.0001),而十二指肠溃疡的患病率相似(分别为11%对12%)。肝硬化患者和对照者中,有胃溃疡和十二指肠溃疡者的幽门螺杆菌感染率相似(分别为83%对80%和88%对96%)。此外,在我们的研究中,50例(12%)肝硬化患者中有6例既往胃十二指肠出血的原因是幽门螺杆菌相关的消化性病变。
结论
我们的结果表明,幽门螺杆菌感染与肝硬化患者消化性溃疡的发病机制有关,这与非肝硬化患者的研究结果相似。