乙肝病毒 百分百伤胃!

liver411

有些人得了乙肝还犯胃病，究竟是什么原因呢?医生解释道，这是乙肝病毒引起的胃粘膜损害所致，乙肝病毒是一种泛嗜性病毒，除侵犯肝脏外，侵犯胃粘膜为其常见的肝外损害。

乙肝患者出现消化道症状，如上腹部不适，中上腹隐痛、腹胀、返酸、纳差、恶心及呕吐时，应当引起注意，除了是肝炎本身的症状外，还要及时做胃镜检查，以明确是否伴有胃粘膜损害。乙肝患者，在治疗肝病服用药物时，要尽量避免服用对胃粘膜有刺激、有损害的药物，根据病情、病程、年龄及胃镜观察结果，考虑选用助消化药物等，这样有利于改善患者的消化功能，减轻或消退消化道症状。同时，饮食上避免辛辣食物的刺激，戒除烟酒，对保肝健胃大有裨益。

据临床发现乙肝并发胃粘膜损害的发生率高达100%。且粘膜病变弥漫而广泛，以胃底、胃体部为主。乙肝合并慢性胃炎的发生率达70%~80%。合并消化性溃疡病的发生率达30%左右。

乙肝病毒造成胃粘膜损害的原因可能与下列因素有关：

①免疫功能紊乱，产生自体免疫反应，导致胃粘膜损害。

②乙肝病毒存在于胃粘膜上皮细胞内，由于乙肝抗原——抗体免疫复合物在细胞中沉积而引起炎症反应，从而削弱和破坏了胃粘膜的屏障保护作用。

③肝功能受损后，肝脏对激素的灭活功能减退，白蛋白的含量降低，这就减弱了对胃粘膜的修复能力。

④患乙肝后，胃酸形成的功能紊乱，导致胃酸过多，过多的胃酸会损害胃粘膜，胃酸过多与胃馈疡的发生相关。

⑤有些慢性乙肝患者有不同程度的肝硬化、门脉高压，使胃血流缓慢，胃粘膜下淤血，胃粘膜因缺血缺氧及营养障碍而致损害。

⑥药物刺激所引起。乙肝患者，特别是慢性乙肝患者需较长时间服药。病人求愈心切，往往服药种类过多，或几种药同时服下，忽视了药物间的相互作用会对胃粘膜产生刺激。有些药物本身就对胃粘膜有刺激作用，特别是有些苦寒性中草药对胃有一定的刺激作用。

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Zhong Xi Yi Jie He Xue Bao. 2005 Jan;3(1):19-22.
[Relationship between hepatitis B virus in gastric mucosa and syndrome of disharmony between liver and stomach in patients with chronic hepatitis B].
[Article in Chinese]

Xia JY, Zhou YY, Zhao YY.

Department of Infectious Diseases, The fifth affiliated Hospital, SUN Yat-sen University, Zhuhai, Guangdong Province 519000, China. [email protected]
Abstract
OBJECTIVE: To study the relationship between the infection of hepatitis B virus (HBV) in gastric mucosa and the syndrome of disharmony between liver and stomach.

METHODS: Subjects were divided into 2 groups: 30 patients with chronic hepatitis B (CHB) and the syndrome of disharmony between liver and stomach in hepatitis group, and 30 patients with chronic gastritis and the syndrome of disharmony between liver and stomach in gastritis group. Liver function and the markers of HBV were detected. The contents of HBV-DNA in serum and in gastric mucosa were assayed respectively by fluorescence quantitative polymerase chain reaction (FQ-PCR).

RESULTS: (1) The incidence of gastric mucosal lesion in hepatitis group was up to 96.7% (29/30). (2) Scores of the syndrome of disharmony between liver and stomach in hepatitis group were significantly lower than those in gastritis group (P<0.05). The positive rates of HBV-DNA in serum, gastric fundus, body and antrum were 56.7%, 76.7%, 76.7% and 70.0%, respectively. (3) A positive correlation was found not only among the content of HBV-DNA in serum and the contents of HBV-DNA in gastric mucosa (r=0.66-0.94, P<0.01), but also among the contents of HBV-DNA in serum, gastric mucosa and the total score of the syndrome of disharmony between liver and stomach in hepatitis group (r=0.36-0.52, P<0.05).

CONCLUSION: The infection of HBV is involved in the syndrome of disharmony between liver and stomach. Gastric mucosal lesion is universal in CHB patients with the syndrome of disharmony between liver and stomach.

PMID: 15644154 [PubMed - indexed for MEDLINE]Free Article

Publication Types, MeSH Terms, Substances
LinkOut - more resourcesZhong Xi Yi Jie He Xue Bao. 2005 Jan;3(1):19-22.
[Relationship between hepatitis B virus in gastric mucosa and syndrome of disharmony between liver and stomach in patients with chronic hepatitis B].
[Article in Chinese]

Xia JY, Zhou YY, Zhao YY.

Department of Infectious Diseases, The fifth affiliated Hospital, SUN Yat-sen University, Zhuhai, Guangdong Province 519000, China. [email protected]
Abstract
OBJECTIVE: To study the relationship between the infection of hepatitis B virus (HBV) in gastric mucosa and the syndrome of disharmony between liver and stomach.

METHODS: Subjects were divided into 2 groups: 30 patients with chronic hepatitis B (CHB) and the syndrome of disharmony between liver and stomach in hepatitis group, and 30 patients with chronic gastritis and the syndrome of disharmony between liver and stomach in gastritis group. Liver function and the markers of HBV were detected. The contents of HBV-DNA in serum and in gastric mucosa were assayed respectively by fluorescence quantitative polymerase chain reaction (FQ-PCR).

RESULTS: (1) The incidence of gastric mucosal lesion in hepatitis group was up to 96.7% (29/30). (2) Scores of the syndrome of disharmony between liver and stomach in hepatitis group were significantly lower than those in gastritis group (P<0.05). The positive rates of HBV-DNA in serum, gastric fundus, body and antrum were 56.7%, 76.7%, 76.7% and 70.0%, respectively. (3) A positive correlation was found not only among the content of HBV-DNA in serum and the contents of HBV-DNA in gastric mucosa (r=0.66-0.94, P<0.01), but also among the contents of HBV-DNA in serum, gastric mucosa and the total score of the syndrome of disharmony between liver and stomach in hepatitis group (r=0.36-0.52, P<0.05).

CONCLUSION: The infection of HBV is involved in the syndrome of disharmony between liver and stomach. Gastric mucosal lesion is universal in CHB patients with the syndrome of disharmony between liver and stomach.

PMID: 15644154 [PubMed - indexed for MEDLINE]Free Article

Publication Types, MeSH Terms, Substances
LinkOut - more resources

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风中的尘

411老师帮我看看:
检查:两对半定量检查.
1.表面抗原>225.00(标准0--0.5),
2表面抗体4.708(标准0-10)
3E抗原0.335(标准0-0.5)
4E抗体0.18(标准0-0.2)
5核心抗体3.722(标准0-0.9)
15项阳性,小三阳.
HBV-DNA335000
肝功能:总胆红素17.4(标准5.1-17.2)其它正常.
血脂六项:
高密度脂蛋白0.80(标准0.82-1.92,),
低密度脂蛋白4.23(标准2.1-3.9)
甘油三脂1.49(0.38-1.92),其它正常.
B超:右肝上界在第六肋间,肋下未见,肝大小形态正常,包膜光滑,实质回声增粗,增强,肝肾实质回声比值增大,肝内血管走向欠清晰.提示:中度脂肪肝.
肝纤四项:1透明质酸216(标准0-110)
2层粘蛋白74(标准0-150)
3,IV型胶原200(标准0-80)
4,III型前胶原150(标准0-120)
(备注,2001年肝病发作才知道患有乙肝)

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