Rasmi Yousef, Farshid Saman, Makhdomi Khadijeh
Department of Biochemistry, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
Saudi J Kidney Dis Transpl. 2012 May;23(3):489-92.
Digestive tract complications are common in hemodialysis (HD) patients, and Helicobacter pylori (H. pylori) is thought to play an important role in the pathogenesis of gastrointestinal mucosal lesions in these patients. Also, reports indicate that cytotoxin-associated gene A (CagA) is the major factor involved in the pathogenesis of H. pylori disease. However, many issues regarding H. pylori infection in HD patients are still unclear. In this cross-sectional study, we investigated the effect of duration on HD on the prevalence of H. pylori infection and its virulent CagA(+) strain. One-hundred and fifty-one HD patients who were referred to our university HD center were included in the study. There were 78 males and 73 females, with a mean age of 54.2 ± 14.6 years (range: 19-87 years). They were tested for serum anti-H. pylori IgG antibody by the enzyme-linked immunosorbent assay method. Also, anti-CagA IgG antibody was tested in H. pylori-infected patients. The study patients were categorized into two groups: short-term HD duration (STHD: ≤3 years) and long-term HD duration (LTHD: >3 years). The overall prevalence of antibodies to H. pylori and CagA were 65.6% (99/151) and 25.3% (25/99), respectively. The prevalence of H. pylori infection among the STHD and LTHD patients were 49/89 (55.10%) and 49/62 (79.0%), respectively; P <0.05. The prevalence of anti-CagA antibody in infected STHD and LTHD patients was 24.5% (12/49) and 26.5% (13/49), respectively; P >0.05. Our study suggests that the prevalence of H. pylori infection is higher in patients on LTHD. More investigations are needed regarding the clinical consequences of H. pylori infection in HD patients.
消化道并发症在血液透析（HD）患者中很常见，幽门螺杆菌（H. pylori）被认为在这些患者胃肠道黏膜病变的发病机制中起重要作用。此外，报告表明细胞毒素相关基因A（CagA）是幽门螺杆菌疾病发病机制中的主要因素。然而，关于HD患者幽门螺杆菌感染的许多问题仍不清楚。在这项横断面研究中，我们调查了HD持续时间对幽门螺杆菌感染及其毒性CagA(+)菌株流行率的影响。本研究纳入了151名转诊至我校HD中心的HD患者。其中男性78名，女性73名，平均年龄54.2±14.6岁（范围：19 - 87岁）。通过酶联免疫吸附测定法检测他们血清中的抗幽门螺杆菌IgG抗体。此外，对幽门螺杆菌感染患者检测抗CagA IgG抗体。研究患者分为两组：短期HD持续时间（STHD：≤3年）和长期HD持续时间（LTHD：>3年）。幽门螺杆菌和CagA抗体的总体流行率分别为65.6%（99/151）和25.3%（25/99）。STHD和LTHD患者中幽门螺杆菌感染的流行率分别为49/89（55.10%）和49/62（79.0%）；P<0.05。感染的STHD和LTHD患者中抗CagA抗体的流行率分别为24.5%（12/49）和26.5%（13/49）；P>0.05。我们的研究表明，长期HD患者中幽门螺杆菌感染的流行率更高。关于HD患者幽门螺杆菌感染的临床后果，还需要更多的研究。
