Natural Course of Helicobacter pylori Infection in Japanese Hemodialysis Patients.
Natural Course of Helicobacter pylori Infection in Japanese Hemodialysis Patients.
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日本血液透析患者幽门螺杆菌感染的自然过程。
DOI：
10.1159/000475659
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
Andoh A.
中科院分区：
文献类型：
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作者：
Sugimoto M;Sahara S;Ichikawa H;Sakao Y;Ohashi N;Sugimoto K;Yasuda H;Furuta T;Andoh A.
摘要幽门螺杆菌感染是血液透析患者胃肠道疾病的主要危险因素之一。主要目的是调查血液透析患者幽门螺杆菌感染率。作为次要终点，我们澄清了胃蛋白酶原（PG）水平是否与血液透析患者幽门螺杆菌感染状况有关。方法测定血清PGⅰ、ⅱ、抗- h水平。对500例日本血液透析患者进行了幽门螺杆菌IgG抗体检测。幽门螺杆菌感染率为15.0%（75/500;95% CI 12.0 ~ 18.4）。幽门螺杆菌阳性者血液透析时间为4.6±3.8年，明显短于幽门螺杆菌阴性者（7.3±6.9年，p= 0.001）。PG I水平与PG II水平、PG I/II比值呈正相关（| R|= 0.661, p< 0.001, | R|= 0.544, p< 0.001）。截断值为7.75，PG I/II比值预测幽门螺杆菌阴性的敏感性和特异性分别为86.3和87.8%（曲线下面积0.930）。结论血液透析患者幽门螺杆菌感染率< 20%，且长期血液透析患者幽门螺杆菌感染率较低。PG I/II比值的临界值为7.75，可能有助于筛选幽门螺杆菌状态。
IntroductionHelicobacter pylori (H. pylori) infection is one of the major risk factors for gastrointestinal morbidity in hemodialysis patients. Primary end point is to investigate H. pylori infection rate in hemodialysis patients. As secondary end point, we clarified whether pepsinogen (PG) level was related with H. pylori infection status in hemodialysis patients.MethodsSerum levels of PG I, II, and anti-H. pylori IgG antibody were assessed in 500 Japanese hemodialysis patients.ResultsH. pylori infection rate was 15.0%(75/500; 95% CI 12.0-18.4). The duration of hemodialysis in H. pylori-positives was 4.6±3.8 years, which was significantly shorter than in H. pylori-negatives (7.3±6.9, p= 0.001). PG I levels positively correlated with the PG II level and PG I/II ratio (| R|= 0.661, p< 0.001, and| R|= 0.544, p< 0.001, respectively). Using a cutoff value of 7.75, the sensitivity and specificity of PG I/II ratio for predicting H. pylori-negatives were 86.3 and 87.8%, respectively (area under the curve 0.930).ConclusionsIn hemodialysis patients, infection rate with H. pylori was< 20%, with lower rates in patients receiving hemodialysis for longer terms. A PG I/II ratio with a cutoff value of 7.75 may be useful for screening for H. pylori status.