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幽门螺杆菌感染性结节性胃炎患者缺铁与血清前铁调素水平的关系。

The relationship between iron deficiency in patients with Helicobacter pylori-infected nodular gastritis and the serum prohepcidin level.

作者信息

Sato Yuichi, Yoneyama Osamu, Azumaya Masaki, Takeuchi Manabu, Sasaki Syun-ya, Yokoyama Junji, Shioji Kazuhiko, Kawauchi Yusuke, Hashimoto Satoru, Nishigaki Yuuki, Kobayashi Masaaki, Sugimura Kazuhito, Honma Terasu, Narisawa Rintaro, Aoyagi Yutaka

机构信息

Department of Gastroenterology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

出版信息

Helicobacter. 2015 Feb;20(1):11-8. doi: 10.1111/hel.12170. Epub 2014 Sep 25.

Abstract

BACKGROUND AND AIMS

Helicobacter pylori (H. pylori) is recognized as a causative agent for unexplained iron-deficiency anemia (IDA). We evaluated many background factors influencing an iron-deficiency state in adult patients with various H. pylori-infected upper gastrointestinal tract diseases.

METHOD

Study 1: H. pylori-infected 121 patients (nodular gastritis (NG) (n = 19), duodenal ulcer (DU) (n = 30), or gastric ulcer (GU) (n = 47), or gastric hyperplastic polyp (GHP) (n = 25)) were enrolled. The RBC count and hemoglobin, iron, ferritin, pepsinogen (PG) I, PG II, gastrin, and anti-H. pylori antibody (Ab) levels in the serum were measured. Study 2: H. pylori-infected 105 patients (NG, n = 19; DU, n = 43; GU, n = 32; GHP, n = 11) and non-H. pylori-infected individuals (n = 35) were examined for the levels of prohepcidin, ferritin, and iron in the serum. In addition, we measured the data before and after the H. pylori eradication.

RESULTS

In the patients with GHP and NG, hypoferritinemia was observed in comparison with the GU and DU patients. In the GHP patients, low levels of PG I, a decreased PG I/II ratio, and hypergastrinemia were observed. The levels of serum prohepcidin in the patients with H. pylori-associated disease were higher than those in the uninfected adults. In the patients with NG, the serum prohepcidin levels were higher than those in the other H. pylori-infected patient groups and decreased after the eradication.

CONCLUSION

H. pylori-related iron-deficiency state might be associated with several factors, such as hypochlorhydria and hepcidin, in patients with GHP or NG.

摘要

背景与目的

幽门螺杆菌(H. pylori)被认为是不明原因缺铁性贫血(IDA)的致病因素。我们评估了影响各种幽门螺杆菌感染的上消化道疾病成年患者缺铁状态的多种背景因素。

方法

研究1:纳入121例幽门螺杆菌感染患者(结节性胃炎(NG)(n = 19)、十二指肠溃疡(DU)(n = 30)、胃溃疡(GU)(n = 47)或胃增生性息肉(GHP)(n = 25))。检测血清中的红细胞计数、血红蛋白、铁、铁蛋白、胃蛋白酶原(PG)I、PG II、胃泌素和抗幽门螺杆菌抗体(Ab)水平。研究2:检测105例幽门螺杆菌感染患者(NG,n = 19;DU,n = 43;GU,n = 32;GHP,n = 11)和35例未感染幽门螺杆菌个体的血清中前铁调素、铁蛋白和铁水平。此外,我们还测量了幽门螺杆菌根除前后的数据。

结果

与GU和DU患者相比,GHP和NG患者出现低铁蛋白血症。GHP患者PG I水平低、PG I/II比值降低和高胃泌素血症。幽门螺杆菌相关疾病患者的血清前铁调素水平高于未感染的成年人。NG患者的血清前铁调素水平高于其他幽门螺杆菌感染患者组,根除后降低。

结论

在GHP或NG患者中,幽门螺杆菌相关的缺铁状态可能与胃酸过少和铁调素等多种因素有关。

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