Cindoruk Mehmet, Cirak Meltem Yalinay, Unal Selahattin, Karakan Tarkan, Erkan Gulbanu, Engin Doruk, Dumlu Sukru, Turet Sevgi
Gazi University, Faculty of Medicine, Ankara, Turkey.
Eur J Gastroenterol Hepatol. 2008 Jan;20(1):33-6. doi: 10.1097/MEG.0b013e3282efa4f2.
BACKGROUND/AIMS: Several reports indicated an increased prevalence of the Helicobacter species in hepatocellular cancer tissue and in liver samples infected with hepatitis viruses. The frequency of Helicobacter spp. in benign liver diseases was, however, not thoroughly investigated.
Seventy-five consecutive patients with suspected liver disease were enrolled. The indications were hepatitis B virus (n=30), C virus (n=8), B and C dual infection (n=1), nonalcoholic steatohepatitis (n=27), autoimmune hepatitis (n=3), primary biliary cirrhosis (n=1) and idiopathic elevation of liver enzymes (n=5). PCR detection of 16S recombinant RNA gene of Helicobacter spp. was performed on liver samples. PCR products of positive samples were further identified by DNA sequencing. The patients also had upper gastrointestinal endoscopy and gastric biopsy for the detection of H. pylori using histopathology and PCR.
Helicobacter spp. DNA was detected in two out of 75 liver biopsy samples (2.6%), which were typed as H. pylori by DNA sequencing. One of these patients had chronic hepatitis C infection (man, 51 years old) and the other had nonalcoholic steatohepatitis (woman, 44 years old). Fifty-two out of 75 of the patients (69.3%) had H. pylori infection in their stomachs.
We have found that H. pylori infection is much less prevalent in benign liver diseases. The presence of H. pylori in nonalcoholic steatohepatitis (NASH) patients is a novel finding and this finding should be confirmed in a larger series.
背景/目的:多项报告指出,肝细胞癌组织以及感染肝炎病毒的肝脏样本中幽门螺杆菌属的患病率有所上升。然而,幽门螺杆菌属在良性肝病中的出现频率尚未得到充分研究。
连续纳入75例疑似肝病患者。诊断依据包括乙型肝炎病毒(n = 30)、丙型肝炎病毒(n = 8)、乙丙型双重感染(n = 1)、非酒精性脂肪性肝炎(n = 27)、自身免疫性肝炎(n = 3)、原发性胆汁性肝硬化(n = 1)以及不明原因的肝酶升高(n = 5)。对肝脏样本进行幽门螺杆菌属16S重组RNA基因的PCR检测。对阳性样本的PCR产物进行DNA测序以进一步鉴定。患者还接受了上消化道内镜检查和胃活检,采用组织病理学和PCR检测幽门螺杆菌。
75例肝脏活检样本中有2例(2.6%)检测到幽门螺杆菌属DNA,经DNA测序鉴定为幽门螺杆菌。其中1例患者为慢性丙型肝炎感染(男性,51岁),另1例为非酒精性脂肪性肝炎(女性,44岁)。75例患者中有52例(69.3%)胃部存在幽门螺杆菌感染。
我们发现幽门螺杆菌感染在良性肝病中较为少见。非酒精性脂肪性肝炎(NASH)患者中存在幽门螺杆菌这一发现较为新颖,这一发现应在更大规模的研究中得到证实。