肝源性溃疡与幽门螺杆菌及门脉高压性胃病关系的研究

Clinical study between hepatogenic ulcer and both helicobacter pylori infection and portal hypertensive gastropathy

目的:探讨乙肝肝硬化肝源性溃疡(HU)与幽门螺杆菌(Hp)感染及门脉高压性胃病的关系。方法:对本院5年来符合标准的256例行胃镜检查的乙肝肝硬化患者(肝硬化组)及103例慢性乙型肝炎患者(慢性肝炎组)的临床资料进行分析。结果:肝硬化组的溃疡发病率为32.42%(83/256)高于慢性肝炎组的25.24%(26/103),但差异无统计学意义(P>0.05)。肝硬化组Hp阳性感染率为42.58%(109/256),非肝硬化组Hp阳性感染率为35.92%(37/103),两组相比差异无统计学意义(P>0.05)。肝硬化组中,肝源性溃疡伴Hp感染54例,Hp阳性率为65.06%,无肝源性溃疡组Hp感染55例,Hp阳性率为31.79%,两者相比差异有统计学意义(P<0.01)。肝功能Child-Pugh分级A、B、C级HU发生率分别为28.33%(17/60)、28.83%(32/111)、40.00%(34/85),肝功能C级组中HU的发生率比A级组及B级组高,相比较差异有统计学意义。门静脉高压性胃病116例,HU发生率为46.55%(54/116),无门静脉高压性胃病140例,HU发生率为20.71%(29/140),两者比较差异有统计学意义(P<0.01)。重度门静脉高压性胃病HU发生率为60.42%(29/48),轻度门静脉高压性胃病HU发生率为36.76%(25/68),差异有统计学意义(P<0.05)。结论:乙肝肝硬化患者的肝源性溃疡发病率高于慢性肝炎患者,肝功能分级越差,溃疡发病率越高。肝源性溃疡的发生与Hp感染及门脉高压性胃病相关。

Objective： To investigate the relationship between hepatogenic ulcer and both helicobacter pylori infection and portal hypertensive gastropathy. Methods： 103 patients with chronic hepatitis B （cirrhosis group） and 256 liver cirrhosis （chronic hepatitis group） were studied in the past five years. Results： The incidence of liver cirrhosis ulcer was 32.42% （83/256） higher than chronic hepatitis group＇s 25.24% （26/103）, but the difference was not statistically significant （P0.05）. Hp infection rates for positive liver cirrhosis group was 42.58% （109/256）, the hepatocirrhosis group tested positive for Hp infection rate of 35.92% （37/103）, the difference in the two groups was statistically significant （P0.05）. Among the cirrhosis group, liver source ulcer with Hp infection of 54 cases, Hp positive rate of 65.06%, without hepatic source ulcer group Hp infection of 55 cases, Hp positive rate of 31.79%, the difference in a statistically significant （P0.01）. Liver function Child-Pugh grade A, B and C level incidence HU were 28.33% （17/60）, 28.83% （32/111）, 40.00% （34/85）, liver function grade C in the incidence of HU group than A grade group and grade B group high, compared to a statistically significant difference. Of 116 patients with portal hypertension stomach, HU incidence stomach was 46.55% （54/116）, high pressure against a vein of 140 cases, HU incidence stomach was 20.71% （29/140）, both comparative differences had statistically significant （P0.01）. Severe portal hypertension incidence of stomach trouble HU was 60.42% （29/48）, a mild stomach portal hypertension incidence of stomach trouble HU was 36.76% （25/68）, the difference was statistically significant （P0.05）. Conclusion：The morbidity of hepatogenie ulcer in patients with liver cirrhosis is higher than that of the patients with chronic hepatitis B. The incidence rate increases as liver function becomes worse. There is significant relationship between the occurrence of HU and both Hp infectlon and PHG.