Teenan R P, Burgoyne M, Brown I L, Murray W R
University Department of Surgery, Western Infirmary, Glasgow, Scotland.
Transplantation. 1993 Jul;56(1):100-3. doi: 10.1097/00007890-199307000-00018.
An unselected group of 33 renal transplant recipients were examined by upper gastrointestinal endoscopy at between two and four months after transplantation. All abnormal lesions were documented and biopsied and, in addition, random biopsies were obtained from the gastric antrum and from the first part of the duodenum. The biopsies were examined and graded for gastritis and duodenitis and the presence of Helicobacter pylori was noted. Duodenitis was identified in 16 patients and gastritis in 10; four patients had a gastric ulcer. Helicobacter was identified in the gastric antrum of 16 patients (48%) and was strongly associated with symptomatic dyspepsia, with gastritis, and with peptic ulceration. There was no relationship between H pylori and prednisolone dose, serum cyclosporine levels, or renal function. H pylori was found to be common in the upper GI tract of renal transplant recipients and may explain the high prevalence of upper GI pathology in these patients. It is interesting to speculate that immunosuppression may contribute to this, although there is no direct evidence from this study to support this theory.
对一组未经挑选的33名肾移植受者在移植后两到四个月进行了上消化道内镜检查。记录并活检所有异常病变，此外，还从胃窦和十二指肠第一部获取随机活检样本。对活检样本进行检查并对胃炎和十二指肠炎进行分级，同时记录幽门螺杆菌的存在情况。16名患者被诊断为十二指肠炎，10名患者为胃炎；4名患者有胃溃疡。在16名患者（48%）的胃窦中发现了幽门螺杆菌，且与症状性消化不良、胃炎和消化性溃疡密切相关。幽门螺杆菌与泼尼松龙剂量、血清环孢素水平或肾功能之间无关联。发现幽门螺杆菌在肾移植受者的上消化道中很常见，这可能解释了这些患者上消化道病变的高发生率。有意思的是可以推测免疫抑制可能对此有影响，尽管本研究没有直接证据支持这一理论。
