Retrospective Analysis Of Hepatitis B Virus Related Liver Cirrhosis Complicated With Peptic Ulcer

Objective: Hepatitis B virus related liver cirrhosis with peptic ulcer(BLC-PU) isnot scarce in clinic, however, it is often misdiagnosed for the fact that symptoms of livercirrhosis are so obvious and the manifestations of ulcer is often ignored. Therefore, it isvery important to diagnose BLC-PU at its early stage and define the correlation factorsof it. The aim of this study is to investigate the associated factors of hepatitis B virusrelated liver cirrhosis complicated with peptic ulcer: the relationship bettweenhelicobacter pylori (H.pylori) infection and BLC-PU, the occurrence site of BLC-PU,the relationship between esophagogastric varices, the grade of liver function andBLC-PU, respectively, in order to confirm the correlation factors of BLC-PU, thusproviding foundation for effective prevention and treatment of it.Methods1.41inpatients were mainly diagnosed with BLC-PU (28cases with H.pyloripositive,13cases with H.pylori negative), and41inpatients were preliminarilydiagnosed with hepatitis B virus related liver cirrhosis (HBC) in corresponding period(32cases with H.pylori positive,9cases with H.pylori negative), all of the patients areadmitted to the First Affiliated Hospital of Dalian Medical University and DalianCentral Hospital from2002to2012were enrolled for retrospective analysis, in addition,analysis the relationship between H.pylori and hepatitis B virus related BLC-PU.2.203inpatients with simple ulcer and270inpatients with BLC-PU (67caseswith ulcer,203cases without ulcer) from2010to2012were selected. The lesion sitesof them were observed by gastroscope, meanwhile, the differences between BLC-PUand PU were analyzed statistically.3.43inpatients who were diagnosed with hepatitis Bvirus related liver cirrhosishad the HBV-DNA detection (23cases with ulcer,20cases without ulcer) the relationship between viral load and the occurrence of BLC-PU were analyzedretrospectively according with the demands in corresponding period.4.63inpatients who accompanying with esophageal and (or) gastric fundic varices(43cases with ulcer,20cases without ulcer) were admitted the relationship between theoccurrence of ulcer and the severity of varices were retrospective analysis fitting thedemands in corresponding period5.111inpatients with a diagnosis of BLC-PU and performed grade of liverfunction(74cases with ulcer,37cases without ulcer) who were retrospectively analyzedthe relationship between of the grade of liver function and on the occurrence ofBLC-PU according with the demands in corresponding period.Results1. The relationship between infection of H.pylori and BLC-PU: in the group ofcases with BLC-PU，H. pylori was positive in41cases, of which28cases were with H.pylori positive（68.29%） and13cases with H. pylori negative（31.7%）. In the groupof cases without ulcer, H. pylori was positive in41cases, of which32cases were withH. pylori positive（78%） and9cases with H. pylori negative（22%）. The differencesof the results of two groups had no statistical difference（P=0.319＞0.05）.2. Characteristics of BLC-PU and simple ulcer: the common occurrence sitesincluded gastric antrum（11cases with BLC-PU,20cases with PU）, gastric angle（11cases with BLC-PU,20cases with PU）, gastric body （2cases with BLC-PU,5caseswith PU）, gastric fundus（1cases with BLC-PU,2cases with PU）, duodenal bulb（31cases with BLC-PU,138cases with PU）, multiple ulcers （11cases with BLC-PU,18cases with PU）. The occurrence sites in the group of BLC-PU, bulb occupied46.27%and multiple ulcers occupied16.42%, while in the group of PU, bulb occupied67.98%and multiple ulcers occupied8.87%. There was no statistical difference among the7groups（P=0.164＞0.05）.3. The relationship between the occurrence of BLC-PU and the load ofHBV-DNA: in the group of BLC-PU(23cases), the load in20cases was greater than5×10~2copy/ml（86.96%），and the load in3cases was less than5×10~2copy/ml; in thegroup without ulcer (20cases), the load of12cases was greater than5×10~2copy/ml（60%）,and the load of8cases was less than5×10~2copy/ml. There is a statisticaldifference between two groups.（P=0.035<0.05）.4. The relationship between the occurrence of BLC-PU and the severity of theaccompanying esophageal and (or) gastric fundic varices: there were16cases with mild varices and BLC-PU（69.57%）7cases without BLC-PU; there were9cases withmoderate varices and BLC-PU（56.25%）7cases without BLC-PU；there were18caseswith serious varices and BLC-PU （75%）6cases without BLC-PU. There is statisticaldifference between mild and serious group and moderate and serious group（P<0.05）5. The relationship between the occurrence of BLC-PU with ulcer and the grade ofliver function: in the group with BLC-PU,40cases were in grade A（57.14%），19caseswere in grade B（79.17%），and15cases were in grade C（82.24%）；while in the groupwithout ulcer,30cases were in grade A,5cases were in grade B and2cases were ingrade C. There is statistical difference among three groups or each two groups hadstatistical significance（P<0.05）.Conclusions1. The relationship between the occurrence of BLC-PU and infection rate ofH.pylori is not clearly defined.2. BLC-PU commonly occurs in duodenal bulb, and multiple ulcers are morecommon than PU.3. The occurrence of BLC-PU is closely related to the esophagogastric varicoseseverity, the grade of liver function and viral load.