慢性乙型病毒性肝炎的幽门螺杆菌感染

Helicobacter pylori- infection in chronic hepatitis B*

目的由于慢性乙型肝炎（乙型肝炎）时幽门螺杆菌（Ｈｐ）感染的报道罕见，因而本研究旨在探讨乙型肝炎患者的Ｈｐ感染状态．方法乙型肝炎患者４４例，采用酶联免疫吸附试验检测血清乙型肝炎病毒（ＨＢＶ）标志物，并采用聚合酶链反应测定ＨＢＶＤＮＡ来确定ＨＢＶ感染．同时通过血清学、尿素酶试验、组织学染色和细菌培养，进行Ｈｐ检查．结果乙型肝炎患者的消化性溃疡发生率为１３６％（６／４４）；Ｈｐ感染率为６１４％（２７／４４）．ＨＢｅＡｇ和（或）ＨＢＶＤＮＡ阳性者Ｈｐ感染率为６３０％（１７／２７），高于ＨＢｅＡｇ和ＨＢＶＤＮＡ皆阴性者的３５３％（６／１７）．此外，以组织学染色确定Ｈｐ感染的阳性率最高．结论乙型肝炎患者Ｈｐ感染率高。

AbstractAIM To observe the Helicobacter pylori (H.pylori) prevalence in patients with chronic hepatitis B virus (HBV) infection due to few reports on H.pylori- infection in HBV infected subjects.METHODS HBV infection was confirmed based on detections of serum HBV markers using enzyme linked immunosorbent assay and of HBV-DNA using polymerase chain reaction. H.pylori infection was examined in 44 patients with chronic hepatitis B by serological test, rapid ureas test, histological stain and culture.RESULTS The prevalence of peptic ulcer in hepatitis B patients was 13.6%(6/44), and the prevalence of H.pylori infection 614% (27/44). The infection rate of H.pylori was 63.0% (17 of 27) in HBeAg and/or HBV-DNA positive patients, and 35.3% (6 of 17) in both HBeAg and HBV-DNA negative patients. In addition, histological stain of gastric biopsies was found to be the best technique for diagnosis of H.pylori- infection.CONCLUSION H.pylori- infection is more prevalent in patients with chronic hepatitis B. It may be responsible for peptic ulcer in these patients.