Giannini E, Fasoli A, Borro P, Chiarbonello B, Malfatti F, Romagnoli P, Botta F, Testa E, Fumagalli A, Polegato S, Savarino V, Testa R
Gastroenterology Unit and Postgraduate School of Gastroenterology and Digestive Endoscopy, Department of Internal Medicine, University of Genoa, Italy.
Aliment Pharmacol Ther. 2001 Dec;15(12):1967-73. doi: 10.1046/j.1365-2036.2001.01117.x.
Helicobacter pylori gastric infection has been associated with various digestive and extra-digestive diseases. The systemic influence of gastric H. pylori infection seems to be mediated by the release of various cytokines. In liver disease, bacterial infections have been associated with the impairment of liver metabolic function.
To evaluate the influence of H. pylori infection on liver function as assessed by means of the monoethylglycinexylidide test, which depends upon liver blood flow and cytochrome P-450 activity, and the 13C-galactose breath test, which depends on cytosolic enzymatic activity and is correlated with hepatic functional mass. Moreover, to evaluate whether H. pylori-associated modifications of liver function may be related to tumour necrosis factor-alpha serum levels.
Thirty-five patients with liver cirrhosis of various aetiologies, who underwent monoethylglycinexylidide and 13C-galactose breath tests, were retrospectively evaluated for H. pylori infection by means of anti-H. pylori immunoglobulin G. The main clinical, biochemical and functional characteristics of the patients as well as their tumour necrosis factor-alpha serum levels were then analysed on the basis of the presence of H. pylori infection.
Twenty-one patients tested positive for H. pylori infection (60%), and 11 tested negative (31.4%). No clinical or biochemical differences were observed between H. pylori-infected and non-infected patients. H. pylori infection showed no difference in distribution according to Child-Pugh classes (A, 55%; B and C, 67%). The monoethylglycinexylidide test results were significantly lower at each sampling time in H. pylori-positive patients compared to H. pylori-negative patients (MEGX15, P=0.027; MEGX30, P=0.014; MEGX60, P=0.028), while 13C-galactose breath test showed no significant differences considering both cumulative percentage dose and percentage dose/h. The median tumour necrosis factor-alpha serum levels were no different between H. pylori-positive (16.1 pg/mL, 95% confidence interval, 8.7-28.7) and H. pylori-negative (12.3 pg/mL, 95% confidence interval, 8.7-23.4) patients.
In cirrhotic patients, H. pylori infection seems to selectively affect cytochrome P-450 liver activity, while hepatic functional mass does not seem to be impaired. Tumour necrosis factor-alpha does not seem to be the mediator of this impairment. Further studies are needed to evaluate the impact of H. pylori eradication on parameters of liver function.
幽门螺杆菌胃部感染与多种消化系统和非消化系统疾病相关。胃部幽门螺杆菌感染的全身影响似乎是由多种细胞因子的释放介导的。在肝脏疾病中，细菌感染与肝脏代谢功能受损有关。
通过依赖肝血流量和细胞色素P-450活性的单乙基甘氨酰二甲苯蓝试验以及依赖胞质酶活性且与肝功能总量相关的13C-半乳糖呼气试验，评估幽门螺杆菌感染对肝功能的影响。此外，评估幽门螺杆菌相关的肝功能改变是否可能与肿瘤坏死因子-α血清水平有关。
对35例不同病因的肝硬化患者进行了单乙基甘氨酰二甲苯蓝试验和13C-半乳糖呼气试验，并通过抗幽门螺杆菌免疫球蛋白G对幽门螺杆菌感染进行回顾性评估。然后根据幽门螺杆菌感染情况分析患者的主要临床、生化和功能特征以及他们的肿瘤坏死因子-α血清水平。
21例患者幽门螺杆菌感染检测呈阳性（60%），11例呈阴性（31.4%）。幽门螺杆菌感染患者和未感染患者之间未观察到临床或生化差异。幽门螺杆菌感染在Child-Pugh分级（A，55%；B和C，67%）中的分布无差异。与幽门螺杆菌阴性患者相比，幽门螺杆菌阳性患者在每个采样时间的单乙基甘氨酰二甲苯蓝试验结果均显著降低（MEGX15，P=0.027；MEGX30，P=0.014；MEGX60，P=0.028），而13C-半乳糖呼气试验在累积剂量百分比和剂量百分比/小时方面均未显示出显著差异。幽门螺杆菌阳性患者（16.1 pg/mL，95%置信区间，8.7 - 28.7）和幽门螺杆菌阴性患者（12.3 pg/mL，95%置信区间，8.7 - 23.4）的肿瘤坏死因子-α血清中位数水平无差异。
在肝硬化患者中，幽门螺杆菌感染似乎选择性地影响肝脏细胞色素P-450活性，而肝功能总量似乎未受损。肿瘤坏死因子-α似乎不是这种损害的介质。需要进一步研究以评估根除幽门螺杆菌对肝功能参数的影响。
