Effects of Helicobacter pylori infection on common lethal factors for hepatitis B virus-related cirrhosis

• Main Authors: LI Yuling, SHAN Zhengfei, SHI Lei
• Format: Article
• Language: zho
• Published: Editorial Department of Journal of Clinical Hepatology 2015-09-01
• Series: Linchuang Gandanbing Zazhi
• Online Access: http://www.lcgdbzz.org/qk_content.asp?id=6755
• ISSN: 1001-5256; 1001-5256

ObjectiveTo study the relationship between Helicobacter pylori (H. pylori) infection and common lethal factors for hepatitis B virus-related cirrhosis (HBC). MethodsA total of 235 patients with HBC who were admitted to our hospitals from October 2008 to October 2014 were retrospectively analyzed. The infection rate of H. pylori in those patients was calculated. In the 155 patients with esophagogastric varices and 97 patients with portal hypertensive gastropathy (PHG), the infection rate of H. pylori was compared between those with different degrees of esophagogastric varices or PHG. In the 32 patients whose blood ammonia was determined, the level of blood ammonia was compared between H. pylori-positive and -negative groups. Between-group comparison of continuous data was performed by t test and analysis of variance, and between-group comparison of categorical data was performed by χ2 test. ResultsThe infection rate of H. pylori in the 235 patients with HBC was 80.85% (190/235). In the 155 patients with esophagogastric varices, who had tortuous serpentine uplift or bead-like changes of esophageal varices and tumor-like changes (with or without gastric erosion) of gastric varices visible under endoscopy, there was significant difference in infection rate of H. pylori between patients with mild, moderate, and severe varices (50.55% (46/91) vs 43.59% (17/39) vs 76% (19/25), χ2=6.913, P＜0.05). In the 97 patients with PHG, who had snake skin-like changes, cherry red spots, scarlet rash, and erosion bleeding of gastric mucosa visible under endoscopy, there was significant difference in infection rate of H. pylori between patients with mild and severe PHG (43.33% (26/60) vs 67.57% (25/37), χ2=5.391, P＜005).In patients whose blood ammonia was determined, patients in H. pylori-positive group had a significantly higher average concentration of blood ammonia than those in H. pylori-negative group (62.76±13.43 vs 47.20±12.51 μmol/L, t= 3.39, P＜0.01). ConclusionThe infection rateof H. pylori is high in patients with HBC. The H. pylori infection is likely to increase the severity of esophagogastric varices and PHG, as well as the blood ammonia level, which further increases the risk of upper gastrointestinal bleeding and hepatic encephalopathy that are the main lethal factors for HBC.