囊性纤维化、胃十二指肠炎症、十二指肠溃疡和 H. pylori 感染：重新审视“囊性纤维化悖论”。
Cystic fibrosis, gastroduodenal inflammation, duodenal ulcer, and H. pylori infection: the "cystic fibrosis paradox" revisited.
机构信息
Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
出版信息
J Cyst Fibros. 2013 Jul;12(4):377-83. doi: 10.1016/j.jcf.2012.11.001. Epub 2012 Nov 30.
BACKGROUND
In cystic fibrosis (CF) patients a duodenal impaired bicarbonate secretion and unbuffered gastric acid are always described and the development of duodenal ulceration is uncommon (CF paradox). Helicobacter pylori (HP) infection is the main cause for duodenal ulceration and its prevalence in CF patients is controversial.
AIM
The objective of this study is to evaluate HP prevalence, gastric histology, and duodenal ulceration in adult FC patients.
METHODS
32 adult CF patients were submitted to (13)C-urea breath test and serum immunoblotting test for HP diagnosis. Among them, 20 patients were submitted to endoscopy.
RESULTS
19/32 (68%) patients showed positive serology. Endoscopy showed erosive duodenitis (15%), and duodenal ulcer scar in 10%. On duodenal histology, 94.5%, showed active inflammation and 66.7% gastric metaplasia.
CONCLUSION
HP infection prevalence in adult CF patients was similar to that of general Brazilian population. CF patients have all the duodenal spectrum of alterations, including duodenal ulcer. CF paradox may not exist.
背景
囊性纤维化（CF）患者常存在十二指肠碳酸氢盐分泌受损和未缓冲胃酸，十二指肠溃疡的发生率较低（CF 悖论）。幽门螺杆菌（HP）感染是十二指肠溃疡的主要病因，但其在 CF 患者中的流行情况存在争议。
目的
本研究旨在评估成年 CF 患者的 HP 感染率、胃组织学和十二指肠溃疡情况。
方法
32 例成年 CF 患者接受了（13）C-尿素呼气试验和血清免疫印迹试验进行 HP 诊断。其中 20 例患者接受了内镜检查。
结果
32 例患者中有 19 例（68%）血清学检查阳性。内镜检查显示糜烂性十二指肠炎（15%）和十二指肠溃疡瘢痕（10%）。十二指肠组织学检查显示，94.5%存在活动性炎症，66.7%存在胃化生。
结论
成年 CF 患者的 HP 感染率与巴西普通人群相似。CF 患者存在所有十二指肠病变谱，包括十二指肠溃疡。CF 悖论可能并不存在。
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