Chen L S, Lin H C, Lee F Y, Hou M C, Lee S D
Department of Medicine, Veterans General Hospital-Taipei, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1995 Oct;56(4):226-31.
The prevalence of duodenal ulcer increases in cirrhotic patients. However, the pathogenesis remains unclear.
The prevalence of duodenal ulcer and their relationship to cirrhosis and portal hypertension were evaluated in 325 cirrhotic patients, and compared with 325 age- and sex-matched healthy subjects. Portal and systemic hemodynamic studies were performed in all cirrhotic patients. Histological examination of gastric antral mucosa for Helicobacter pylori (H. pylori) was performed in 16 cirrhotic patients with duodenal ulcer and in 34 cirrhotic patients without duodenal lesions.
The prevalence of duodenal ulcer in cirrhotic patients was 9.5% (31 out of 325), significantly higher than 4.0% (13 out of 325) in the healthy controls (p = 0.007), but was not related to the severity of liver cirrhosis. The positive rate of H. pylori was not different between cirrhotic patients with duodenal ulcer and those without duodenal lesions (9/16 vs. 18/34, p > 0.05). The hepatic venous pressure gradient was also not different between these groups (17.2 +/- 5.1 vs. 16.1 +/- 4.9 mmHg, p > 0.05). Other variables including sex, smoking, and etiology of cirrhosis did not show significant differences.
The prevalence of duodenal ulcer is significantly higher in cirrhotic patients than in the age- and sex-matched healthy subjects. The severity of cirrhosis, the presence of H. pylori or portal hypertension per se does not play an important role in the increased prevalence of duodenal ulcer in cirrhotic patients.
十二指肠溃疡在肝硬化患者中的患病率增加。然而，其发病机制仍不清楚。
评估了325例肝硬化患者十二指肠溃疡的患病率及其与肝硬化和门静脉高压的关系，并与325例年龄和性别匹配的健康受试者进行比较。对所有肝硬化患者进行了门静脉和体循环血流动力学研究。对16例患有十二指肠溃疡的肝硬化患者和34例无十二指肠病变的肝硬化患者的胃窦黏膜进行了幽门螺杆菌（H. pylori）的组织学检查。
肝硬化患者十二指肠溃疡的患病率为9.5%（325例中有31例），显著高于健康对照组的4.0%（325例中有13例）（p = 0.007），但与肝硬化的严重程度无关。十二指肠溃疡的肝硬化患者与无十二指肠病变的肝硬化患者之间幽门螺杆菌的阳性率无差异（9/16对18/34，p>0.05）。这些组之间的肝静脉压力梯度也无差异（17.2±5.1对16.1±4.9 mmHg，p>0.05）。包括性别、吸烟和肝硬化病因在内的其他变量未显示出显著差异。
肝硬化患者十二指肠溃疡的患病率显著高于年龄和性别匹配的健康受试者。肝硬化的严重程度、幽门螺杆菌的存在或门静脉高压本身在肝硬化患者十二指肠溃疡患病率增加中不起重要作用。
