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[慢性酒精中毒中的胃窦炎。肝硬化和幽门螺杆菌的作用]

[Antral gastritis in chronic alcoholism. Role of cirrhosis and Helicobacter pylori].

作者信息

Altman C, Ladouch A, Briantais M J, Rason T, Martin E, Jacques L, Buffet C

机构信息

Service d'Hépato-Gastroentérologie, Hôpital de Bicêtre, Le Kremlin-Bicêtre.

出版信息

Presse Med. 1995;24(15):708-10.

PMID:7784401
Abstract

OBJECTIVES

Antral gastritis is frequent in alcoholics. The role of H. pylori in the pathogenesis of gastritis in these patients is not well known. The aim of our study was to study the role of H. pylori and cirrhosis in the pathogenesis of antral gastritis in alcoholic patients.

METHODS

Seventy-nine patients were included in the study. All underwent upper gastrointestinal tract endoscopy with antral biopsies, independently of the presence of abdominal pain, and had serological examination for H. pylori antibodies.

RESULTS

Cirrhosis and gastritis were present in 50 and 40 patients respectively, H. pylori serological assay and histological identification of the bacterium were positive in 35 (44%) and 19 (24%) patients respectively. Discrepancy between the 2 tests were observed more frequently in cirrhotic patients. A positive serology with a negative histologic examination for H. pylori was present for 18 cirrhotic and 4 noncirrhotic patients (p < 0.05). A gastritis without evidence of H. pylori was more frequent in cirrhotic than in noncirrhotic patients. H. pylori was histologically present in 11 of 29 cirrhotic patients and in 8 of the 11 noncirrhotic patients with a gastritis (p < 0.05).

CONCLUSIONS

Discrepancies between histological examination and H. pylori serology in patients with cirrhosis might be due to the inhospitable environment for H. pylori in case of portal hypertension; the positive serology could be in relation with a past infection.

摘要

目的

胃窦炎在酗酒者中很常见。幽门螺杆菌在这些患者胃炎发病机制中的作用尚不清楚。我们研究的目的是探讨幽门螺杆菌和肝硬化在酗酒患者胃窦炎发病机制中的作用。

方法

79例患者纳入本研究。所有患者均接受了上消化道内镜检查及胃窦活检,无论是否存在腹痛,并进行了幽门螺杆菌抗体血清学检查。

结果

分别有50例和40例患者存在肝硬化和胃炎,幽门螺杆菌血清学检测和细菌组织学鉴定阳性的患者分别为35例(44%)和19例(24%)。两种检测结果的差异在肝硬化患者中更常见。18例肝硬化患者和4例非肝硬化患者幽门螺杆菌血清学阳性但组织学检查阴性(p<0.05)。无幽门螺杆菌证据的胃炎在肝硬化患者中比在非肝硬化患者中更常见。在29例肝硬化患者中有11例组织学检查发现幽门螺杆菌,在11例患有胃炎的非肝硬化患者中有8例发现幽门螺杆菌(p<0.05)。

结论

肝硬化患者组织学检查与幽门螺杆菌血清学之间的差异可能是由于门静脉高压时幽门螺杆菌的生存环境不佳;血清学阳性可能与既往感染有关。

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