根除幽门螺杆菌对肝硬化患者血氨浓度的影响

目的观察肝硬化合并感染幽门螺杆菌（Hp）患者根除幽门螺杆菌前后血氨浓度的变化。方法确诊的肝硬化住院患者116例,Hp阴性患者设为A组（40例）,Hp阳性（76例）患者随机分为B组（40例）,C组（36例）。三组行护肝治疗和降血氨的标准化治疗,C组在此基础上再加上幽门螺杆菌根除治疗,三组治疗时间为2周,治疗前、治疗1周后、治疗2周后分别测空腹血氨值。结果 Hp感染与血氨浓度关系：阳性组血氨（85.3±25.8）μmol/L浓度高于阴性组（62.9±24.0）μmol/L,差异无显著性（P〉0.05）。Hp治疗前后血氨浓度变化：阳性组76例根除2周后66例转阴,治疗前血氨与治疗后血氨（57.6±27.1）μmol/L比较,差异有显著性（P〈0.05）。Hp感染对不同肝功能期血氨的影响：阳性组76例按Child分级,A级、B级、C级三组之间血氨值比较,差异有显著性（P〈0.05）。阴性组A级、B级、C级之间血氨值比较,差异无显著性（P〉0.05）。结论肝硬化合并感染幽门螺杆菌患者在对其肝硬化常规治疗的同时根除幽门螺杆菌有助于降低血氨浓度,降低患肝性脑病的风险。

Hp eradication therapy in patients with cirrhosis blood ammonia concentration

Objective To study the change of blood ammonia concentration in patients with cirrhosis before and after Helicobacter pylori（Hp） eradication therapy. Method 116 patients were selected as research subjects,including 76 Hp positive cases who were randomly divided into group B（40 cases） and group C（36 cases） and 40 Hp negative cases（group A）. Three groups treated with improving liver function and blood ammonia treatment,in addition to group C treated with Hp eradication therapy. Treatment time was two weeks. Before and after one week,two weeks after treatment respectively measured fasting blood ammonia value. Result Blood ammonia concentration of positive group and negative respectively were（85. 3 ± 25. 8） μmol /L,（62. 9 ± 24. 0） μmol /L. Blood ammonia concentration of positive group were higher than negative group（P〉0. 05）. There was no significant difference. Blood ammonia concentration changed before and after Hp eradication： positive group,76 cases of eradication turned 66 cases after 2 weeks. Before the eradication of blood ammonia concentration,after the eradication of blood ammonia concentration of（57. 6 ～ 27. 1） μmol /L,compared with before the eradication of significant difference（P〈0. 05）,there were significant difference. Hp infection on the influence of different liver function stated of blood ammonia： in 76 patients with positive Child classification according to the liver function,blood ammonia concentration between three groups had significant difference（ P〈0. 05）;Negative group of blood ammonia concentration had no significant difference between three groups（ P〉0. 05）. Conclusion hepatocirrhosis with helicobacter pylori infection in patients of liver cirrhosis conventional treatment of helicobacter pylori eradication will help reduced blood ammonia concentration at the same time,to help reduce the risk of hepatic encephalopathy in patients with cirrhosis.