摘要
目的探讨幽门螺杆菌(Hp)感染和肝硬化患者上消化道出血的相关性,以期提高临床治疗质量。方法回顾性分析2011年2月-2012年12月135例肝硬化患者的病历资料,对所有患者进行内镜检查,了解静脉曲张和消化性溃疡的发生情况以及出血的原因,同时对所有患者进行胃黏膜尿素酶试验,检查Hp,观察肝硬化上消化道出血的相关性。结果 135例肝硬化患者中检测出Hp阳性61例,发生率为45.19%;肝功能A级的Hp感染率为45.07%,肝功能B级的Hp感染率为45.45%,肝功能C级的Hp感染率为45.16%,3组的Hp感染率比较差异无统计学意义;无食管静脉曲张的发生率为52.78%,轻度食管静脉曲张的发生率为54.84%,中度食管静脉曲张的发生率为60.87%,3组之间比较差异均无统计学意义;而重度食管静脉曲张的发生率为24.44%,与前三者比较差异有统计学意义(P<0.05);而上消化道出血Hp阳性患者发生率为44.26%,Hp阴性患者发生率为18.92%;135例患者中出现消化性溃疡患者83例,发生率为61.48%,其中Hp阳性患者出血发生率为18.07%,Hp阴性患者为2.41%。结论 Hp参与了肝硬化上消化道出血的致病过程,是造成肝源性溃疡升高和胃黏膜活动性炎症引起出血的原因之一,根治Hp可降低肝硬化上消化道出血的发生率。
OBJECTIVE To investigate the correlation between the Helicobacter pylori （ Hp） infections and uppergastrointestinal bleeding in patients with cirrhosis in order to improve the quality of clinical treatment. METHODSA retrospective analysis was performed for the clinical data of 135 cirrhosis patients who were treated in the hospital from Feb 2011 to Dec 2012 , all the patients underwent the endoscopy to examine the incidence of varicose veinsand peptic ulcer as well as the causes of bleeding, then gastric mucosa urease test was performed, the Hp was detected ,and the correlation between the Hp infections and the upper gastrointestinal bleeding was observed.
RESULTS Of totally 135 patients with cirrhosis investigated,the Hp was tested positive in 61 cases with the positive rate of 45. 19% ; the incidence rate of Hp infections was 45. 07% in the patients with liver function class A,45. 45% in the patients with liver function class B, 45. 16% in the patients with liver function class C, the difference in the incidence of Hp infections between the three groups was not significant. As for the Hp infection andthe degree of esophageal varices, the incidence rate of Hp infections was 52. 78% in the patients without esophageal varices, 54. 84% in the patients with mild esophageal varices,60. 87% in the patients with moderate esophagealvarices, the difference between the three groups was not significant, however, the incidence rate of Hp infectionswas 24. 44% in the patients with severe esophageal varices, as compared with other three groups, the differencewas significant （P〈0. 05）. The incidence of upper gastrointestinal bleeding was 44. 26% in the patients with Hptested positive, 18. 92% in the patients with Hp tested negative. Of totally 135 cases of patients investigated,thepeptic ulcer occurred in 83 cases with the incidence rate of 61. 48% , among which the patients with Hp tested positive accounted for 18. 07%,the patients with Hp tested negative 2. 41 %. CONCLUSION Hp has involved in thepathogenesis of upper gastrointestinal bleeding in the liver cirrhosis patients, which is one of the leading causes ofthe elevated liver ulcer and active gastric mucosal inflammation, to eradicate the Hp may reduce the incidence ofupper gastrointestinal bleeding in the liver cirrhosis patients.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第17期4143-4145,共3页
Chinese Journal of Nosocomiology
基金
贵阳市卫生局专项资助课题(GB-2010B-043)
关键词
肝硬化
幽门螺杆菌
上消化道出血
Cirrhosis
Helicobacter pylori
Upper gastrointestinal bleeding
