慢性乙型肝炎病毒感染者幽门螺杆菌感染调查分析

Investigation and analysis of Helicobacter pylori infection in patients with chronic hepatitis B

目的调查慢性乙型肝炎病毒感染者幽门螺杆菌感染情况,分析患者感染幽门螺杆菌与其并发症发生发展的关系。方法分别采用ELISA法和PCR法测定乙型肝炎病毒血清学标志物及其病毒DNA,采用流行病学调查方法探究幽门螺杆菌感染情况。结果 334例慢性乙型肝炎患者幽门螺杆菌感染阳性者226例,感染率为67.66%。226例幽门螺杆阳性患者血清丙氨酸氨基转氨酶(ALT)和总胆红素(TBil)分别为(150±89)U/L和(38±28)(μmol/L),108例幽门螺杆阴性患者ALT和TBil分别为(82±26)U/L和(27±23)(μmol/L),幽门螺杆感染阳性患者ALT高于幽门螺杆感染阴性患者,差异有统计学意义(χ2=7.0657,P<0.05)。且感染幽门螺杆菌的慢性乙型肝炎患者HBV复制率要高于未感染患者。慢性乙型肝炎病毒感染者并发肝性脑病、血氨增高、自发性腹膜炎、消化道出血时,患者幽门螺杆菌感染的阳性率分别为82.98%、68.11%、70.97%和69.05%。结论慢性乙型肝炎病毒感染者幽门螺杆菌感染率较高,患者感染幽门螺杆菌与其并发症的发生发展相关。

Objective To investigate the prevalence of Helicobacter pylori infection in patients with chronic hepatitis B and to analyze the relationship between H. pylori infection and the occurrence and development of complications. Methods Serologic markers of HBV were detected with ELISA and HBV DNA was detected with PCR, and the prevalence of H. pylori was studied using an epidemiological methodology. Results An H. pylori infection was found in 226 of 334 patients with chronic hepatitis B, for a rate of infection of 67.66 %. In the 226 patients with an H. pylori infection, ALT was 150±89 U/L and TBil was 38±28 μmol/L. In the 108 patients without an H. pylori infection, ALT was 82±26 U/L and TBil was 27 ±23 μmol/L. ALT was significantly higher in patients with an H. pylori infection than in patients without such an infection, and the difference was statistically significant （χ2 = 7. 0657, P〈0.05）. The rate of HBV replication in patients with an H. pylori infection and chronic hepatitis B was significantly higher than in patients without such an infection. Patients with chronic hepatitis B and hepatic encephalopathy had a rate of H. pylori infection of 82.98 %, those with chronic hepatitis B and hyperammonemia had a rate of infection of 68.11%, those with chronic hepatitis B and spontaneous peritonitis had a rate of infection of 70.97%, and those with chronic hepatitis B and gastrointestinal bleeding had a rate of infection of 69.05%. Conclusion The rate of H. pylori infection was higher in patients with chronic hepatitis B, and an H. pylori infection was significantly related to the occurrence and development of complications.