慢性乙型肝炎患者幽门螺杆菌感染状况及其相关因素分析

目的探讨慢性乙型肝炎患者幽门螺杆菌（HP）感染状况。方法采用病例对照研究对502例慢性乙型肝炎患者的抗-HP-IgG和乙型肝炎病毒（HBV）DNA定量及分型进行检测。结果HP感染率在慢性乙型肝炎组（59．5％）、乙型肝炎肝硬化组（77．1％）及合并肝癌组（80．6％）均明显高于健康对照组（43．4％）,且随着病变程度的加重,HP感染率亦增加。HBVDNA阳性组的慢性乙型肝炎患者HP感染率高于HBVDNA阴性组（P〈0．05）和健康对照组（P〈0．001）,但不同病毒载量组之间比较差异无统计学意义。不同HBV基因型之间HP感染率无明显差异。肝硬化合并肝性脑病、消化性溃疡和消化道出血等并发症者HP感染率较高。结论慢性乙型肝炎患者幽门螺杆菌感染率明显增加,且随着病变程度的加重,HP感染率亦增加。乙型肝炎肝硬化患者并发症的发生可能与HP感染有关。     

丙型肝炎特异性诊断的比较及其意义探讨

丙型肝炎特异性诊断的比较及其意义探讨邢益平，Ｓ．Ｂｏｗｄｃｎ，Ｓ．Ｌｏｃａｒｎｉｎｉ自Ｃｈｏｏ等首先发现并应用融合蛋白Ｃ１００－３诊断丙型肝炎以来，一些新的检测特异性抗体或直接检测病毒核酸的诊断方法相继问世，大大提高了丙型肝炎检测的敏感性和特异性。本...     

荧光定量PCR法在丙型肝炎病毒核糖核酸检测中的应用

目的：通过与荧光半定量PCR及传统逆转录PCR（RT-PCR）比较,探讨荧光定量PCR（FQ-PCR）在丙型肝炎病毒核糖核酸（HCV RNA）检测中的应用价值。方法：采用FQ-PCR、荧光半定量PCR及RT-PCR三种方法同步检测180例丙型肝炎患者HCV RNA含量,所得结果采用χ^2检验。结果：FQ-PCR在血浆中及单个核细胞中的阳性检出例数最多,分别占78.3%和83.7%。无论是在血浆中或单个核细胞测定,FQ-PCR阳性检出率均明显高于同步检测的荧光半定量PCR及RT-PCR（P〈0.01）。以RT-PCR为标准,当HCV RNA水平在10^3～5copies/ml时,FQ-PCR和荧光半定量PCR阳性检出水平相一致（P〉0.05）,明显高于RT-PCR（P〈0.01）。当HCV RNA水平在10^6～7cop-ies/ml时,3种检测方法的阳性检出率基本相同（P〉0.05）。结论：FQ-PCR检测HCV RNA具有高灵敏度、高特异性,且二次污染的可能性小。     

慢性丙型肝炎患者血清HCVRNA定量分析：竞争性聚合酶链反应

目的：探讨ＨＣＶ复制水平与肝病进展的关系。方法：用竞争性逆转录聚合酶链反应（ＣＲＴ－ＰＣＲ）定量检测２７例慢性丙肝患者（ＣＨＣ）血清ＨＣＶＲＮＡ。结果：ＣＨＣ患者血清ＨＣＶＲＮＡ水平变化范围１０２～１０６ｃｏｐｉｅｓ／５０ｕｌｓｅｒｕｍ。１３例慢性迁延性肝炎（ＣＰＨ）患者血清ＨＣＶＲＮＡ平均水平（５．０６８±１．０４，Ｌｏｇ１０ｃｏｐｉｅｓ／５０μｌｓｅｒｕｍ）明显低于１０例慢性活动性肝炎患者（ＣＡＨ）（５．７９±０．２５）和４例肝硬化（Ｃｉｒ）患者（５．８３±０．７５），Ｐ值均＜０．０５。血清ＨＣＶＲＮＡ水平同ＡＬＴ水平间呈正相关（ｒ＝０．４９９７，Ｐ值＜０．０５）。结论：表明丙肝病毒感染后病毒血症水平低，ＨＣＶ复制水平与肝损伤相关，在慢性感染中ＨＣＶ仍活跃复制，并与肝病进展相关。     

聚合酶链反应快速检测胃粘膜幽门螺杆菌

本研究的目的是了解简单的PCR方法诊断幽门螺杆菌感染的价值。选用互补于幽门螺杆菌尿素酶A基因片段的一对引物,建立PCR方法扩增幽门螺杆菌DNA,扩增产物经琼脂糖电泳显示一条411bp区带。用PCR扩增41株HP分离菌均阳性,而空肠弯曲菌等8种肠道细菌均阴性,显示100％特异,系列稀释试验显示PCR能检测0.1pg的HP DNA;126例胃粘膜标本用PCR、尿素酶试验、培养和涂片检查,HP检出率分别为70.6％、56.3％、32.5％和56.3％,这些结果提示简单快速的PCR方法是检测HP的有价值的方法。     

聚合酶链反应检测幽门螺杆菌70例报告

聚合酶链反应检测幽门螺杆菌７０例报告李延年，刘先贤（武汉市东西湖区人民医院消化内科武汉４３００７１）１９９０年Ｈｏｓｈｉｎａ等首先应用聚合酶链反应（ＰＣＲ）成功检出胃粘膜活检标本内的ＨＰ。我院从今年１９９年１月份开始，在短短三个月中对７０例胃镜受检者...     

巢式聚合酶链反应扩增幽门螺杆菌尿素酶基因

选用位于幽门螺杆菌（Ｈｐ）尿素酶Ｂ基因上３个引物组成的巢式聚合酶链反应（ＰＣＲ），成功地对Ｈｐ标准菌株及２１４例临床标本进行了扩增，并对样品的准备、ＰＣＲ反应物的组成及ＰＣＲ循环条件方面作了深入的研究，简化了操作程序，缩短了操作时间，降低了消耗。与既往所用的尿素酶试验及Ｗａｒｔｈｉｎ－Ｓｔａｒｒｙ银染色进行比较，显示其具有特异性强、灵敏度高、方法简便、快速且准确等特点，可作为常规检查在临床应用。     

聚合酶链反应检测血液病患者合并丙型肝炎病毒感染

聚合酶链反应检测血液病患者合并丙型肝炎病毒感染杨桂玲，陈文 ，杨碧云，曹瑞生，文艺丙型肝炎病毒（ＨＣＶ）感染是输血后非甲非乙型肝炎的主要原因。在免疫抑制群体如恶性血液病，尤其是化疗或骨髓移植治疗后，以及再生障碍性贫血，常需输血治疗，大大增加了感染的机...     

cagⅡ在胃十二指肠疾病患者幽门螺杆菌中的检出率及其与幽门螺杆菌相关性疾病的关系

目的:探讨cagⅡ在胃十二指肠疾病患者幽门螺杆菌(H.pylori)中的检出率及其与H.pylori相关性疾病的关系.方法:H.pylori菌株分离自107例胃十二指肠疾病患者,其中慢性胃炎67例,消化性溃疡34例,胃癌6例.采用聚合酶链反应(PCR)技术,对107株H.pylori菌株cagⅡ中的597 bp片段进行扩增.结果:107株H.pylori菌株的cagⅡ阳性检出率为69.2%(74/107),慢性胃炎(64.2%)、消化性溃疡(79.4%)和胃癌(4/6)组的检出率无显著差异(P＞0.05).结论:cagⅡ在不同胃十二指肠疾病患者感染的H.pylori中均有检出,其分布与不同H.pylori相关性疾病的关系并不十分密切,cag Ⅱ在H.pylori致病中的意义还有待进一步研究.     

定量检测幽门螺杆菌细胞毒素相关蛋白基因A方法的建立

目的:建立定量检测细胞毒素相关蛋白基因A(cagA)阳性幽门螺杆菌(Hp)的方法。方法:利用含Hp cagA的质粒(P~(MC3))作为外参照品,在微孔板中对PCR扩增cagA的产物进行辣根过氧化物酶标记的探针杂交及酶促显色。结果:当PCR反应体系中原始模板为1～10~5拷贝、循环次数小于或等于25时,原始模板以相对固定的指数形式增加,在该范围内适宜定量分析。通过对20份已知Hp菌株cagA的检测符合率达100％,观察结果的敏感度较电泳法提高了200倍。定量检测不同胃粘膜组织中cagA阳性Hp,检出底限为6拷贝/mg组织。结论:本方法特异性强,敏感度高,对研究Hp与消化道疾病的关系有实用价值。     

慢性乙型肝炎患者幽门螺杆菌感染的调查分析

目的探讨慢性乙型肝炎患者幽门螺杆菌(H.pylori)的感染情况及其临床意义。方法将167例慢性乙型肝炎患者分为肝炎组、肝硬化组、肝癌组,研究H.pylori感染状况与76例健康对照者的关系,并进一步分析H.pylori感染与肝功能、临床并发症的关系。结果慢性乙型肝炎患者H.pylori感染率为64.1%,明显高于健康对照组34.2%(P<0.01)。其中肝硬化组71.8%和肝癌组75.0%又高于肝炎组51.5%(P<0.05)。H.pylori阳性患者肝性脑病、上消化道出血及ALT水平高于H.pylori阴性患者(P<0.05),H.pylori阳性和H.pylori阴性患者的腹水并发症及TBIL差异无统计学意义(P>0.05)。结论慢性乙型肝炎患者H.pylori感染率显著增加,且H.pylori感染可能加重肝病病程。     

慢性乙型病毒性肝炎的幽门螺杆菌感染

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，可能是引起乙型肝炎患者消化性溃疡发生的重要原因     

Helicobacter pylori seroprevalence in cirrhotic patients with hepatitis B virus infection

Liver cirrhosis is a significant cause of death in Italy and one of the most frequent causes of hospitalization. The burden of cirrhotic patients on the National Health System is extremely high due to the frequent need for medical care. Acute peptic ulcer and upper gastrointestinal bleeding reportedly occur in over one-third of cirrhotic patients. Since Helicobacter pylori (H. pylori) infection strongly correlates with peptic ulcer, we wished to ascertain the prevalence of H. pylori infection in cirrhotic patients. In a case-control study we looked for this infection in 45 consecutive male patients suffering from hepatitis B virus (HBV)-related cirrhosis and 310 sex and age matched blood donors resident in the same area. Antibodies against H. pylori were present in 40/45 (89%) patients and 183/310 (59%) blood donors (P<0.001). This very high prevalence of H. pylori may explain the frequent occurrence of gastroduodenal ulcer in cirrhotic patients. (See Editorial p. 203)     

Helicobacter pylori seroprevalence in hepatitis C virus positive patients with cirrhosis

BACKGROUND/AIMS: Liver cirrhosis is a significant cause of death in Italy and one of the most frequent causes of hospitalization. Acute peptic ulcer and upper gastrointestinal bleeding reportedly occur in over one-third of cirrhotic patients. Since Helicobacter pylori (H. pylori) infection strongly correlates with peptic ulcer, we sought to ascertain the prevalence of H. pylori infection in cirrhotic patients. METHODS: In a case-control study, we examined 254 consecutive patients (127 male and 127 female, age range 30-82 years) suffering from hepatitis C virus (HCV)-related cirrhosis and 463 sex- and age-matched patients admitted to the Department of Emergency Care of our hospital (254 male, 209 female, age range 30-79 years) resident in the same area. RESULTS: Antibodies to H. pylori were present in 226/254 (89%) cirrhotic patients and in 275/463 (59%) controls (p<0.0001). The difference was significant both in males and in females. CONCLUSIONS: The very high prevalence of H. pylori infection may explain the frequent occurrence of gastroduodenal ulcer in cirrhotic patients and may possibly determine the prognosis of those who are also infected with HCV.     

慢性乙型肝炎患者幽门螺杆菌感染状况及肝组织螺杆菌属特异性16SrRNA基因分析

目的分析慢性乙型肝炎患者幽门螺杆菌(Hp)感染状况及肝组织螺杆菌属特异性16Sr RNA基因特点。方法纳入维吾尔族CHB患者60例和健康维吾尔族体检者80例,采用14C-尿素呼气试验检测H pylori阳性感染,常规进行肝穿刺,采用PCR法检测肝组织螺杆菌16Sr RNA基因水平。结果慢性乙型肝炎每分钟衰变数(14C-UBT)阳性率为85.00%,显著高于对照组[60.24%,P0.01];在所谓的60例慢性乙型肝炎患者中,经肝组织学检查,发现慢性乙型肝炎46例,肝硬化14例;在46例CHB和14例肝硬化患者肝组织DNA进行16 Sr RNA基因检测,结果 40例(86.96%)CHB和13例(92.86%)肝硬化患者16 s RNA阳性,两组差异无统计学意义(x2=0.363,P0.05);轻度、中度与重度CHB患者肝组织16 s RNA检出率亦无统计学差异(x2=1.348,P=0.510)。结论慢性乙型肝炎患者幽门螺杆菌感染率较高,但肝组织螺杆菌属特异性16Sr RNA检出率与乙型肝炎患者肝组织炎症或纤维化程度未显示出显著性关联。     

Virologic factors related to interferon-alpha-induced thyroid dysfunction in patients with chronic hepatitis C

OBJECTIVE: Hepatitis C virus (HCV), being reported to be associated with a high prevalence of serological markers of autoimmunity in HCV-infected patients, and possibly sharing partial sequences in amino acid segments with thyroid tissue antigens, may be associated with interferon-alpha (IFN-alpha)-induced thyroid dysfunction in chronic hepatitis C patients. We conducted this study to clarify the issue. DESIGN AND METHODS: One hundred and fifty chronic hepatitis C patients with normal baseline thyroid function were treated with IFN-alpha 2a, 2b and n1 (3-6 million Units three times weekly for 24 weeks). Pretreatment sera were tested for HCV genotype and HCV RNA levels. Serum thyrotropin, total thyroxine and free thyroxine index were performed every 4 weeks for 24 weeks followed by every 8 weeks for another 24 weeks. RESULTS: Twenty-one (14.0%) patients developed early thyroid dysfunction (abnormal thyroid function during the first 3 months of therapy). Female gender, lower HCV RNA levels, IFN-alpha n1 and a lower IFN-alpha dose were significantly associated with early thyroid dysfunction. On multivariate analysis, gender, IFN-alpha preparation and HCV RNA levels were the significant factors associated with early thyroid dysfunction. Seven (4.7%) patients developed thyroid dysfunction during the second 3 months of IFN-alpha therapy. Taken together, 18.7% patients developed thyroid dysfunction. Female, mixed HCV genotype infection and lower HCV RNA levels were significantly associated with thyroid dysfunction. However, only gender remained significantly associated with IFN-alpha-induced thyroid dysfunction in multivariate analysis. CONCLUSIONS: The virologic features of HCV may be associated with thyroid dysfunction in chronic hepatitis C patients treated with IFN-alpha. Nevertheless, gender still plays the most important role in IFN-alpha-induced thyroid dysfunction.     

Helicobacter pylori infection and gastric function in patients with chronic idiopathic dyspepsia.

Helicobacter pylori infection, histological features of the gastric mucosa, and gastric motor and secretory functions were evaluated in 45 consecutive patients with chronic idiopathic dyspepsia. H. pylori infection was found in 60% of dyspeptic patients, compared with 33% of 15 healthy controls (P = 0.1). No difference was detected in basal or stimulated gastric acid secretion between dyspeptic patients and healthy controls. Gastric emptying was significantly (P less than 0.01) delayed in dyspeptic patients compared with healthy controls when standardized for age and sex. Delayed gastric emptying was associated with a low frequency of H. pylori infection, female gender, and young age. Epigastric pain or burning and postprandial fullness were, respectively, more severe in patients with H. pylori infection (P less than 0.02) and in those with delayed gastric emptying (P less than 0.01). These findings support the existence of separate subsets of patients with chronic idiopathic dyspepsia. Despite the presence of overlaps, there appear to be partially different functional derangements and clinical features in different subgroups of dyspeptic patients.     

Helicobacter pylori infection and related gastrointestinal diseases

Helicobacter pylori has been implicated in the pathogenesis of a number of digestive tract disorders, such as chronic active gastritis, peptic ulceration, gastric cancer, and mucosa-associated lymphoid tissue lymphoma. Disease outcome is dependent on many factors, including bacterial genotype, host physiology and genetics, and environmental factors such as diet. Researchers continue to explore the complexities of H. pylori infection, seeking to explain why some individuals have asymptomatic infection, whereas others experience clinical disease. The importance of treating H. pylori infection in patients with gastrointestinal problems has been confirmed in recent years, with clinical trials showing that cure of infection can prevent duodenal ulcer and, to a lesser extent, gastric ulcer recurrence; cure early stage mucosa-associated lymphoid tissue lymphoma; and reduce the chances of developing gastric cancer in high-risk individuals.