慢性丙型肝炎患者血清抗Hp抗体与临床特征的关系

Detection of anti-Hp-IgG seroprevalence and its relation to aging,HCV load and HCV genotypes in patients with chronic hepatitis C

目的探讨幽门螺杆菌(Helicobacter pylori,Hp)在慢性丙型肝炎中的作用。方法采用病例对照研究的方法分析282例慢性丙型肝炎患者的Hp感染状况与年龄变化、HCV RNA载量和HCV RNA分型的关系。结果Hp感染率随年龄变化无明显差异(P>0.05),Hp感染率在慢性丙型肝炎组(55.6%)、丙型肝炎肝硬化组(76.5%)和丙型肝炎合并肝癌组(78.6%)明显高于健康对照组(43.4%)(均P<0.01),各组与慢性胃炎组(57.9%)相比较无明显差异(P>0.05),其中肝硬化组和合并肝癌组Hp感染率均高于肝炎组(P<0.05)。不同病毒载量的慢性丙型肝炎患者的Hp感染率均明显高于健康对照组(P<0.01),但不同病毒载量之间无明显差异(P>0.05)。慢性丙型肝炎患者基因1a型、1b型、2a型和2b型患者Hp感染率分别为60.0%、64.8%、61.0%和62.7%,各基因型之间比较无明显差异(P>0.05)。结论慢性丙型肝炎患者Hp感染率明显增加,且Hp感染率随着肝病病变程度的进展而增加。

Objective To explore the role of Hp in chronic hepatitis C. Methods The seroprevalence of Hp infection with different age and the quantity and genotyping of HCV RNA in 282 chronic hepatitis C patients were detected. Results Hp seropositivity had no significant difference in patients with different age （ P 〉 0. 05 ）. Hp seropositivity was more prevalent among patients with chronic hepatitis C （55. 6% ） , chronic cirrhosis of HCV （76. 5% ） , and HCV-related HCC （78. 6% ） than that in controls of blood donors （43.4%） （P 〈 0. 01 ） ; but had no obvious difference from that in chronic gastritis （57.9%） （ P 〉 0. 05 ） ; that of chronic cirrhosis group and HCC group was higher than that in chronic hepatitis group （ P 〈 0. 05 ）. Hp seropositivity in the patients with different quantity of HCV was higher than that in blood donors （P 〈0.01 ） ; but there was no significant difference among the different quantity of virus （P 〉 0. 05 ）. Hp seropositivity in chronic hepatitis C patients with genotype la,lb,2a and 2b was 60. 0% , 64. 8%, 61.0% and 62.7% respectively. But there was no significant difference among the genotypes （ P 〉 0. 05 ）. Conclusions Seroprevalence of antibodies to Hp is found to be higher in patients with chronic hepatitis C, and Hp seropositivity increases with pathological changes of chronic hepatitis C.