Gür G, Boyacioglu S, Gül C, Turan M, Gürsoy M, Baysal C, Ozdemir N
Gastroenterology Department, Biochemistry Division and Nephrology Department, Baskent University, Ankara, Turkey.
Nephrol Dial Transplant. 1999 Nov;14(11):2688-91. doi: 10.1093/ndt/14.11.2688.
Helicobacter pylori infection is associated with increased gastrin release in patients with normal renal function. Hypergastrinaemia is a common finding in haemodialysis patients and, in many cases, may be linked to H. pylori infection. The aim of this study was to examine the effect of H. pylori infection, and its eradication, on elevated gastrin levels in haemodialysis patients.
Eighty-nine dyspeptic patients were included in the study. While 44 patients had normal renal function, the remaining 45 were end-stage renal failure patients. Patients were assigned to one of four groups according to their H. pylori and renal function status. Infected patients were re-evaluated after 2 months following eradication treatment. Serum gastrin levels were measured in these groups both before and after eradication treatment.
Haemodialysis patients with H. pylori infection had higher serum gastrin levels than did H. pylori negative haemodialysis patients (321+/-131 pg/ml vs 154+/-25 pg/ml) (P<0.05). Mean serum gastrin concentration was 152+/-21 pg/ml in the non-uraemic H. pylori-positive group. This value was 58+/-17 pg/ml in the non-uraemic H. pylori-negative group (P<0.05). There were significant decreases in serum gastrin levels from pre- to post-eradication of H. pylori in the infected haemodialysis and non-uraemic patient groups (312+/-131 pg/ml to 179+/-85 pg/ml and 152+/-21 pg/ml to 72+/-2.4 pg/ml respectively, P<0.05). Four patients in group Ib and 5 patients in group IIb who had persistent infection did not have a decrease in serum gastrin level. All patients with successful eradication had a decrease in serum gastrin concentration.
Our findings suggest that H. pylori infection contributes to hypergastrinaemia in haemodialysis patients. More research is needed regarding the clinical consequences of hypergastrinaemia in these individuals.
幽门螺杆菌感染与肾功能正常患者胃泌素释放增加有关。高胃泌素血症在血液透析患者中很常见，在许多情况下，可能与幽门螺杆菌感染有关。本研究的目的是探讨幽门螺杆菌感染及其根除对血液透析患者胃泌素水平升高的影响。
89例消化不良患者纳入本研究。其中44例患者肾功能正常，其余45例为终末期肾衰竭患者。根据幽门螺杆菌和肾功能状况，将患者分为四组之一。感染患者在根除治疗2个月后重新评估。在根除治疗前后，对这些组的血清胃泌素水平进行测量。
幽门螺杆菌感染的血液透析患者血清胃泌素水平高于幽门螺杆菌阴性的血液透析患者（321±131 pg/ml对154±25 pg/ml）（P<0.05）。非尿毒症幽门螺杆菌阳性组的平均血清胃泌素浓度为152±21 pg/ml。非尿毒症幽门螺杆菌阴性组的值为58±17 pg/ml（P<0.05）。在感染的血液透析和非尿毒症患者组中，根除幽门螺杆菌前后血清胃泌素水平有显著下降（分别从312±131 pg/ml降至179±85 pg/ml和从152±21 pg/ml降至72±2.4 pg/ml，P<0.05）。Ib组的4例患者和IIb组的5例持续感染患者血清胃泌素水平没有下降。所有成功根除的患者血清胃泌素浓度均下降。
我们的研究结果表明，幽门螺杆菌感染导致血液透析患者高胃泌素血症。关于这些个体高胃泌素血症的临床后果，还需要更多的研究。
