Durazzo Marilena, Pellicano Rinaldo, Premoli Alberto, Berrutti Mara, Leone Nicola, Ponzetto Antonio, Rizzetto Mario
Department of Internal Medicine, University of Turin, Italy.
Dig Dis Sci. 2002 Feb;47(2):380-3. doi: 10.1023/a:1013782408510.
Autoimmune hepatitis is characterized by a continuing hepatocyte necrosis that usually progresses to liver cirrhosis. Autoimmunity is also a feature of chronic infection by Helicobacter pylori, a gram-negative bacterium involved in the pathogenesis of peptic ulcer and upper gastrointestinal bleeding, with both events frequently occurring in patients with chronic liver disease. A newly described pathogenetic mechanism for chronic hepatitis and hepatocellular carcinoma in the mouse is linked to Helicobacter spp. infection. A high prevalence of H. pylori infection was demonstrated in patients with viral-related cirrhosis but never studied in cases of autoimmune hepatitis. In a case-control study, we examined 31 consecutive patients (25 women and 6 men, age range 20-66, mean age 46 +/- 4.3 years) suffering from autoimmune hepatitis and 62 sex- and age-matched blood donors (50 women, 12 men, age range 20-65, mean age 46 +/- 5.4 years) resident in the same area. Antibodies to H. pylori were present in 20 of 31 (64.5%) autoimmune patients compared to 33 of 62 (53.2%) controls (P = 0.3, odds ratio 1.60, 95% CI 0.60-4.28). The difference was not statistically significant either in female or male patients. In conclusion, the prevalence of H. pylori infection in patients and controls was similar in our study of patients with chronic autoimmune hepatitis.
自身免疫性肝炎的特征是持续的肝细胞坏死,通常会发展为肝硬化。自身免疫也是幽门螺杆菌慢性感染的一个特征,幽门螺杆菌是一种革兰氏阴性菌,参与消化性溃疡和上消化道出血的发病机制,这两种情况在慢性肝病患者中经常出现。最近在小鼠中描述的一种慢性肝炎和肝细胞癌的发病机制与幽门螺杆菌感染有关。在病毒相关性肝硬化患者中已证实幽门螺杆菌感染的高患病率,但在自身免疫性肝炎病例中从未进行过研究。在一项病例对照研究中,我们检查了31例连续的自身免疫性肝炎患者(25名女性和6名男性,年龄范围20 - 66岁,平均年龄46±4.3岁)和62名居住在同一地区、年龄和性别匹配的献血者(50名女性,12名男性,年龄范围20 - 65岁,平均年龄46±5.4岁)。31例自身免疫性患者中有20例(64.5%)存在幽门螺杆菌抗体,而62例对照中有33例(53.2%)存在(P = 0.3,比值比1.60,95%可信区间0.60 - 4.28)。在女性或男性患者中,差异均无统计学意义。总之,在我们对慢性自身免疫性肝炎患者的研究中,患者和对照中幽门螺杆菌感染的患病率相似。