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目的探讨乙肝病毒(HBV)感染对慢性乙肝、肝硬化患者胃黏膜病变的影响及其发病机制。方法2003-06～2004-02对河北医科大学第三医院感染科60例慢性乙肝、肝硬化患者同时行肝穿、胃镜、肝功能、血清肝炎病毒标志物检查,采用SP法检测肝及胃黏膜组织中HBsAg、HBcAg。结果(1)肝组织病理损害程度与胃黏膜病变程度成正比(r=0.483,P<0.01)。(2)56例中26例胃黏膜组织中可检测到HBsAg和(或)HBcAg,其病变以中重度为主。34例HBVM阴性患者中,病变以轻中度为主(P<0.01)。(3)肝组织与胃黏膜组织中HBsAg同时阳性17例;HBcAg同时阳性6例(P>0.05)。(4)血清及胃黏膜组织中HBsAg和(或)HBcAg同时阳性26例;HBVDNA同时阳性22例(P>0.05)。结论进一步证实了HBV可侵犯胃黏膜组织,并在其中复制,是导致慢性乙肝患者胃黏膜病变的重要因素。胃黏膜病变程度与胃黏膜组织HBV感染、肝组织病变程度密切相关;与血清及肝组织中HBV分布无关。
Objective To investigate the effect of hepatitis B virus (HBV) infection on gastric mucosal lesions in patients with chronic hepatitis B and cirrhosis and its pathogenesis. Methods From June 2003 to February 2004, 60 patients with chronic hepatitis B and cirrhosis from Department of Infectious Diseases, the Third Hospital of Hebei Medical University were enrolled in this study. Liver, gastroscope, liver function and serum hepatitis B virus markers were examined at the same time. Liver and gastric mucosa Tissue HBsAg, HBcAg. Results (1) The degree of liver damage was proportional to the degree of gastric mucosal lesions (r = 0.483, P <0.01). (2) HBsAg and / or HBcAg were detectable in 26 cases of gastric mucosa in 56 cases, with moderate and severe lesions. Of the 34 HBVM negative patients, the lesions were mild to moderate (P <0.01). (3) 17 cases of positive HBsAg in liver tissue and gastric mucosa at the same time; 6 cases of HBcAg positive at the same time (P> 0.05). (4) Serum and gastric mucosa tissue HBsAg and (or) HBcAg simultaneously positive in 26 cases; HBVDNA positive at the same time in 22 cases (P> 0.05). Conclusions further confirmed that HBV can invade gastric mucosal tissue, and in which replication, is an important factor in the pathogenesis of gastric mucosal lesions in patients with chronic hepatitis B. Gastric mucosal lesions and gastric mucosal tissue HBV infection, liver disease is closely related to the degree; and serum and liver tissue has nothing to do with the distribution of HBV.