Gladziwa U, Haase G, Handt S, Riehl J, Wietholtz H, Dakshinamurty K V, Glöckner W M, Sieberth H G
Department of Internal Medicine II, Technical University of Aachen, Germany.
Nephrol Dial Transplant. 1993;8(4):301-6.
The prevalence of Helicobacter pylori (H. pylori) was investigated in 164 consecutive patients with different degrees of renal function; group I (normal renal function) n = 84, group II (chronic renal failure, CLCR > or = 5 < 90 ml/min) n = 45, group III (haemodialysis therapy) n = 35, to test the hypothesis that the resulting different concentrations of urea in the gastric juice would have an influence on the colonization of the gastric mucosa by these urea-splitting bacteria. As every individual method for the detection of H. pylori shows disadvantages, the results of the detection methods used (urease test, Warthin-Starry stain, bacterial cultivation, direct examination of the processed sample by phase-contrast microscopy) were combined in a cumulative evaluation. These calculated cumulative indices for the antrum and corpus showed no statistically significant differences between the studied groups. The prevalence of H. pylori ranged from 34 to 54%. The histopathological findings were similar in all groups. In spite of the fact that patients with renal dysfunction had significantly higher levels of serum gastrin (P < 0.05), there was no influence on the gastric juice pH value. The relationship between the cumulative index and ammonia concentration in gastric juice was found to be linear (P < 0.05). The higher urea levels in the blood and gastric juice of patients with renal failure do not seem to be a risk factor for infection with H. pylori.
对164例不同程度肾功能的连续患者进行了幽门螺杆菌（H. pylori）感染率调查；第一组（肾功能正常）n = 84，第二组（慢性肾衰竭，CLCR≥5＜90 ml/min）n = 45，第三组（血液透析治疗）n = 35，以检验胃液中不同浓度尿素会对这些分解尿素细菌在胃黏膜定植产生影响这一假设。由于每种检测幽门螺杆菌的单独方法都存在缺点，因此将所使用检测方法（尿素酶试验、Warthin-Starry染色、细菌培养、相差显微镜直接检查处理后的样本）的结果进行综合评估。这些计算得出的胃窦和胃体累积指数在各研究组之间无统计学显著差异。幽门螺杆菌感染率在34%至54%之间。所有组的组织病理学结果相似。尽管肾功能不全患者的血清胃泌素水平显著更高（P＜0.05），但对胃液pH值没有影响。发现累积指数与胃液中氨浓度之间呈线性关系（P＜0.05）。肾衰竭患者血液和胃液中较高的尿素水平似乎不是幽门螺杆菌感染的危险因素。
