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血液透析患者中的幽门螺杆菌感染

Helicobacter pylori infection in hemodialysis patients.

作者信息

Tsukada Katsuhiko, Miyazaki Tatsuya, Katoh Hiroyuki, Yoshikawa Minako, Masuda Norihiro, Ojima Hitoshi, Tajima Kohei, Fukai Yasuyuki, Nakajima Masanobu, Kamiyama Youichi, Kuwano Hiroyuki, Tsukada Osamu

机构信息

Department of First Surgery, Gunma University School of Medicine 3-39-22 Showamachi Maebashi, 371-8511 Japan.

出版信息

Hepatogastroenterology. 2003 Nov-Dec;50(54):2255-8.

Abstract

BACKGROUND/AIMS: Studies on the relationship between high serum urea nitrogen, creatinine and Helicobacter pylori infection in hemodialysis patients still give conflicting results. In the present study we investigated the prevalence of Helicobacter pylori positivity in patients with hemodialysis [HD(+)] and without hemodialysis [HD(-)] and assessed the relationship between clinical factors, serum urea nitrogen, creatinine levels and Helicobacter pylori prevalence in these patients.

METHODOLOGY

117 patients with dyspeptic complaints were included in the study. They consisted of 36 HD(+) patients (31%) and 81 HD(-) patients (69%). Endoscopy was performed and gastric antral biopsies were obtained for immunohistochemical analysis for Helicobacter pylori in all patients.

RESULTS

Helicobacter pylori was positive in 53(45%) of 117 patients [Hp(+)]. In univariate analysis Hp(+) patients received hemodialysis therapy significantly less often (P = 0.002) and had lower serum urea nitrogen (P = 0.0008) and creatinine (P = 0.003) levels than Hp(-) patients. There was no significant difference in age, gender, endoscopic findings or comorbid conditions (hypertension or diabetes mellitus) between these groups. Multivariate logistic regression analysis revealed that only the serum urea nitrogen level was significantly associated with Helicobacter pylori prevalence (P = 0.008).

CONCLUSIONS

These results indicate that high serum urea nitrogen seems to correlate with a low prevalence of Helicobacter pylori infection and hemodialysis patients with high serum urea nitrogen may be protected against Helicobacter pylori infection.

摘要

背景/目的:关于血液透析患者高血清尿素氮、肌酐与幽门螺杆菌感染之间关系的研究结果仍存在争议。在本研究中,我们调查了接受血液透析[HD(+)]和未接受血液透析[HD(-)]患者的幽门螺杆菌阳性率,并评估了这些患者的临床因素、血清尿素氮、肌酐水平与幽门螺杆菌感染率之间的关系。

方法

117例有消化不良症状的患者纳入本研究。其中36例HD(+)患者(31%),81例HD(-)患者(69%)。对所有患者进行内镜检查并获取胃窦活检组织进行幽门螺杆菌免疫组化分析。

结果

117例患者中有53例(45%)幽门螺杆菌阳性[Hp(+)]。单因素分析显示,与Hp(-)患者相比,Hp(+)患者接受血液透析治疗的频率显著更低(P = 0.002),血清尿素氮(P = 0.0008)和肌酐(P = 0.003)水平更低。这些组之间在年龄、性别、内镜检查结果或合并症(高血压或糖尿病)方面无显著差异。多因素逻辑回归分析显示,只有血清尿素氮水平与幽门螺杆菌感染率显著相关(P = 0.008)。

结论

这些结果表明,高血清尿素氮似乎与幽门螺杆菌感染率低相关,血清尿素氮高的血液透析患者可能对幽门螺杆菌感染有保护作用。

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