The Influence Of Helicobacter Pylori Infection On The Risk Of Common Complications In Hepatitis B Virus Related Liver Cirrhosis

Objective: The role of helicobacter pylori (H. pylori) infection on hepatitis B virus related liver cirrhosis (HBC) is poorly defined. Because lesion of gastrointestinal mucous membrane and injury of vascular induced by cirrhosis with portal hypertension can lead to upper gastrointestinal bleeding(HGB), and H. pylori can decompose urease to produce ammonia which may result in hepatic encephalopathy(HE), we investigated the prevalence of H. pylori infection in HBC and the relationship of H. pylori to esophagogastric varices, portal hypertensive gastropathy (PHG) and levels of blood ammonia in patients with HBC, aiming to know if there is any influence of helicobacter pylori infection on the risk of common complications in HBC.Methods:1. 235 inpatients with HBC of the First Affiliated Hospital of Dalian Medical University from the year 2002 to 2011 were collected for retrospective analysis, and 198 inpatients with chronic superficial gastritis were admitted in the corresponding period. The H. pylori infection rate of them was studied respectively.2. 155 inpatients of HBC with esophageal and (or) gastric fundic varices in the corresponding period were enrolled for retrospective analysis (82 cases with H. pylori positive, 73 ones with negative), to study and analysis the relationship between H. pylori infection and severity of esophagogastric varices.3. 97 inpatients of HBC with PHG in the corresponding period were enrolled for retrospective analysis (51 cases with H. pylori positive,46 ones with negative), to study and analysis the relationship between H. pylori infection and severity of PHG.4. 32 cases of outpatients or inpatients with HBC in the same hospital from the year 2010 to 2011 were enrolled (17 ones with H. pylori positive, 15 cases with negative), to study and analysis the relationship between H. pylori infection and levels of blood ammonia.Results:1. The infection rate of H. pylori :There was a significant difference between the H. pylori infection rate in patients with liver cirrhosis (80.85%; 190/235) and that in patients with chronic superficial gastritis (61.62%; 122/198), P<0.01.2. The relationship between H. pylori infection and severity of esophagogastric varices: Patients with esophagogastric varices were divided into mild, moderate and severe groups. In the mild group, 46 patients were H. pylori positive and 45 cases were negative, in the moderate group ,17 patients positive and 22 ones negative, while in the severe group, 19 cases were H. pylori positive and 6 ones were negative.There were evident differences among the three groups and every both two groups of them( P <0.05), except the comparation between the mild and moderate group.3. The relationship between H. pylori infection and severity of PHG :Patients with PHG were separate into mild and severe groups. In the mild group, 26 patients were H. pylori positive and 25 cases were negative, while in the severe group, 34 cases were H. pylori positive and 12 ones were negative.There was a significant difference between the two groups, P<0.05.4. The relationship between H. pylori infection and levels of blood ammonia: The level of blood ammonia in 17 patients with H. pylori positive was 62.76±13.43μmol/L, and the concentration of blood ammonia in 15 patients with H. pylori negative was 47.20±12.51μmol/L, P <0.01.Conclusions:1. The prevalence of the infection from H. pylori in patients with HBC is higher than that in normal population.2. The infection of H. pylori is related to the severity of esophagogastric varices and PHG in HBC, which promoting the risk of HGB.3. H. pylori infection is correlated to the levels of blood ammonia in HBC, which inducing the risk of HE.