慢性乙型肝病及肝源性溃疡与幽门螺杆菌感染_0.docVIP

慢性乙型肝病及肝源性溃疡与幽门螺杆菌感染 【摘要】 目的 探讨慢性乙型肝病及肝源性溃疡与幽门螺杆菌（Helicobacter pylori，Hp）感染的关系。 方法 慢性乙型肝炎患者342例，乙型肝炎后肝硬化患者298例，非慢性肝病患者229例，均行抗Hp-IgG抗体血清学检测及快速尿素酶试验。 结果 慢性乙型肝炎、乙型肝炎后肝硬化及非慢性肝病对照组的Hp感染率分别为51.5%、45.0%和72.9%。肝源性溃疡Hp感染率为46.3%，而对照组消化性溃疡Hp阳性率为82.1%。 结论 慢性乙型肝病患者的Hp感染率与对照组相比较低，Hp感染不是肝源性溃疡发生的重要原因。 【关键词】 幽门螺杆菌；乙型肝炎；肝硬化；消化性溃疡 Hepatitis B virus-related chronic liver disease,hepatogenic ulcer and Helicobacter pylori infection 【Abstract】 Objective To investigate the role of Helicobacter pylori (H.pylori ) infection in patients with hepatitis B virus-related chronic liver disease and hepatogenic ulcer. Methods 342 patients with chronic hepatitis B and 298 liver cirrhosis were studied. 229 age-matched individuals with no evidence of hepatitis B virus (HBV) infection or liver diseases served as control. Serum samples from these groups were tested for specific IgG antibodies to H.pylori， using enzyme-linked immunosorbent assay (ELISA). The re were also used for rapid urease test. Results The prevalence of H.pylori in patients with hepatitis B、liver cirrhosis and control group were 51.5%、 45.0% and 72.9% respectively. H.pylori infection was 46.3% in patients with hepatogenic ulcer， that was significantly lower than 82.1% in peptic ulcer of control patients (P0.005). Conclusion The incidence of H.pylori infection in hepatitis B virus-related liver disease was significantly lower than in non-chronic liver disease group. H.pylori infection might not be the main etiological factor for hepatogenic ulcer. 【Key words】 Helicobacter pylori； hepatitis B；liver cirrhosis；peptic ulcer 幽门螺杆菌（Hp）感染是慢性胃炎的直接病因，并且与消化性溃疡的发生密切相关。其与胃外疾病的相关性已受到关注，慢性乙型肝病与Hp感染的关系以及二者协同感染时是否导致更为严重的胃黏膜损伤 目前 尚不明确［1］，本文旨在探讨慢性乙型肝病患者Hp感染状况以及Hp感染与肝源性溃疡（Hepatogenic ulcer，HU）的关系。 1 材料与方法 1.1 病例来源 2001年1月～2006年1月就诊于天津市第一中心 医院 消化内科患者869例。慢性乙型肝炎患者342例，男234例，女108例；乙型肝炎后肝硬化患者298例，男214例，女84例，年龄25～70岁；对照组229例，为同期非慢性肝病患者，男141例，女88例，年龄21～65岁。所有患者进入 研究 前30天未服用过含铋制剂、质子泵抑制剂及其他 抗菌药物，无长期服用非甾体抗炎药物史，既往无明确胃病史。各组间患者年龄、性别差异无显著性。 1.2 方法 血清抗Hp-I