Blusiewicz K, Rydzewska G, Rydzewski A
Dialysis Unit, Regional Hospital, Grajewo, Poland.
Rocz Akad Med Bialymst. 2005;50:188-92.
This study was undertaken to test the hypothesis that high concentrations of urea in gastric juice would have an influence on Helicobacter pylori infection in patients maintained on chronic hemodialysis (HD).
We investigated 30 patients (17 males, 13 females; mean age 50.8 +/- 2.9 years) with end-stage renal disease (ESRD) undergoing hemodialysis treatment (HD) for at least 6 months, who were compared to 31 patients (16 males, 15 females; mean age 61.3 +/- 2.2 years) with dyspeptic symptoms. Biopsies from the gastric antrum and body were taken for histological investigation. Urea and ammonia were measured in gastric juice, and the severity of gastritis was evaluated according to Sydney criteria.
H. pylori infection was found in 19 (63%) HD patients and in 22 (71%) control subjects. Gastric juice urea concentration was significantly higher in HD patients than in controls and H. pylori infection caused a significant decrease in urea concentration in both groups. There was an inverse correlation between urea and ammonia concentration in gastric juice in both groups. Ammonia concentration in both groups was higher in H. pylori infected patients. In H. pylori negative subjects ammonia/urea ratio was lower in HD patients in comparison to controls. Ammonia/urea ratio was raised by H. pylori infection in both groups, and the difference between HD and control groups persisted. H. pylori infection was associated with polymorphonuclear infiltration of gastric mucosa. There was a significant correlation between gastric ammonia and mucosal polymorphonuclear leukocytes infiltration and gastritis score.
Higher urea levels in the gastric juice of chronically hemodialyzed patients do not seem to be a risk factor for infection with Helicobacter pylori.
本研究旨在验证以下假设：慢性血液透析（HD）患者胃液中高浓度尿素会对幽门螺杆菌感染产生影响。
我们调查了30例终末期肾病（ESRD）患者（17例男性，13例女性；平均年龄50.8±2.9岁），他们接受血液透析治疗（HD）至少6个月，并与31例有消化不良症状的患者（16例男性，15例女性；平均年龄61.3±2.2岁）进行比较。采集胃窦和胃体的活检组织进行组织学检查。测定胃液中的尿素和氨，并根据悉尼标准评估胃炎的严重程度。
19例（63%）HD患者和22例（71%）对照者发现幽门螺杆菌感染。HD患者胃液尿素浓度显著高于对照组，幽门螺杆菌感染导致两组尿素浓度显著降低。两组胃液中尿素和氨浓度呈负相关。幽门螺杆菌感染患者两组的氨浓度均较高。在幽门螺杆菌阴性受试者中，HD患者的氨/尿素比值低于对照组。两组幽门螺杆菌感染均使氨/尿素比值升高，HD组与对照组之间的差异持续存在。幽门螺杆菌感染与胃黏膜多形核白细胞浸润相关。胃氨与黏膜多形核白细胞浸润及胃炎评分之间存在显著相关性。
长期血液透析患者胃液中较高的尿素水平似乎不是幽门螺杆菌感染的危险因素
