幽门螺杆菌感染与原发性胆汁性胆管炎的关系研究  

A study of the correlation between Helicobacter pylori infection and primary biliary cholangitis

作　　者：黄江梅 高云堃 张桂林 朱英嵽 黄华[1] 赵公芳[1] HUANG Jiang-mei;GAO Yun-kun;ZHANG Gui-lin(Department of Gastroenterology,The Second Affiliated Hospital of Kunming Medical University,Kunming 650000,China)

机构地区：[1]昆明医科大学第二附属医院消化内科,650000

出　　处：《中国现代药物应用》2025年第2期30-33,共4页Chinese Journal of Modern Drug Application

基　　金：云南省“万人计划”名医人才专项(项目编号:YNWR-MY-2019-074)。

摘　　要：目的 分析幽门螺杆菌(Hp)感染与原发性胆汁性胆管炎(PBC)的关系。方法 359例PBC且行Hp检测的患者,依据Hp检测结果分为Hp阳性组(n=202)和Hp阴性组(n=157)。收集两组患者的一般资料;检测并比较两组患者的肝功能指标[白蛋白(ALB)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、谷氨酰转肽酶(GGT)]、炎症指标[白细胞介素-6(IL-6)、C反应蛋白(CRP)]、自身免疫性抗体[抗线粒体M2型抗体(AMA-M2抗体)及抗gp210、抗sp100、抗SSA、抗SSB抗体]阳性率。结果 359例PBC患者,检出Hp阳性202例,阳性率为56.3%。Hp阳性组ALT、AST、ALP、GGT水平分别为48.00(24.00,103.00)、66.00(38.00,115.00)、193.00(128.00,374.00)、127.00(48.00,357.00)U/L,高于Hp阴性组的39.00(18.00,77.50)、45.00(28.00,72.00)、161.00(105.00,276.50)、88.00(34.00,289.00)U/L,差异有统计学意义(P<0.05);Hp阳性组ALB 32.40(26.80,39.40)g/L低于Hp阴性组的39.30(35.30,41.70)g/L,差异有统计学意义(P<0.05)。Hp阳性组IL-6、CRP水平分别为7.51(6.50,15.78)pg/ml、5.07(2.48,10.94)mg/L,高于Hp阴性组的3.12(1.51,6.95)pg/ml、1.14(0.30,3.30)mg/L,差异有统计学意义(P<0.05)。Hp阳性组的抗gp210抗体阳性率37.6%高于Hp阴性组的27.4%,差异有统计学意义(P<0.05);两组患者的AMA-M2、抗sp100、抗SSA、抗SSB抗体阳性率比较,差异无统计学意义(P>0.05)。结论 PBC患者中Hp感染率较高,且与肝功能损伤、炎症因子水平和抗gp210抗体密切相关。Objective To analyze the correlation between Helicobacter pylori(Hp) infection and primary biliary cholangitis(PBC).Methods 359 patients with PBC who underwent Hp test were divided into Hppositive group(n=202) and Hp-negative group(n=157) according to Hp test results.Collection of general data of the two groups;detection and comparison of liver function[ albumin(ALB),alanine aminotrasferase(ALT),aspartate transaminase(AST),alkaline phosphatase(ALP),gamma-glutamyl transpeptidase(GGT)],inflammatory markers[ interleukin-6(IL-6),C-reactive protein(CRP)],and positive rate of autoimmune antibodies[anti-mitochondrial M2(AMA-M2),anti-gp210,anti-sp100,anti-SSA,anti-SSB antibodies] between the two groups.Results Among 359 PBC patients,202 were positive for Hp,with a positivity rate of 56.3%.The levels of ALT,AST,ALP and GGT in Hp-positive group were 48.00(24.00,103.00),66.00(38.00,115.00),193.00(128.00,374.00) and 127.00(48.00,357.00) U/L,which were higher than 39.00(18.00,77.50),45.00(28.00,72.00),161.00(105.00,276.50),88.00(34.00,289.00)U/L in Hp-negative group,and the difference was statistically significant(P<0.05).ALB 32.40(26.80,39.40) g/L in Hp-positive group was lower than 39.30(35.30,41.70) g/L in Hp-negative group,and the difference was statistically significant(P<0.05).The levels of IL-6 and CRP in Hp-positive group were 7.51(6.50,15.78) pg/ml and 5.07(2.48,10.94) mg/L,which were higher than 3.12(1.51,6.95) pg/ml and 1.14(0.30,3.30) mg/L in Hp-negative group.The difference was statistically significant(P<0.05).The positive rate of anti-gp210 in Hp-positive group was 37.6%,which was higher than 27.4% in Hp-negative group,and the difference was statistically significant(P<0.05).There was no significant difference in the positive rates of AMA-M2,anti-sp100,anti-SSA and anti-SSB antibodies between the two groups(P>0.05).Conclusion Hp infection rate is higher in PBC patients,and it is closely related to liver function injury,inflammatory factor level and anti-gp210 antibody.

关 键 词：幽门螺杆菌 原发性胆汁性胆管炎 自身免疫性肝病 肝功能 抗gp210 

分 类 号：R575.7[医药卫生—消化系统] R573[医药卫生—内科学]