根除幽门螺杆菌对肝硬化患者血氨和脑电图变化的临床观察

目的 探讨肝硬化患者的幽门螺杆菌(Hp)感染情况并观察根除Hp后肝硬化患者血氨和脑电图的变化.方法 确诊的肝硬化患者52例,经胃镜或14C尿素呼气试验明确Hp感染情况,对Hp阳性者进行Hp根除治疗(一周标准三联疗法),方案为奥美拉唑40 mg/d,克拉霉素1.0 g/d,阿莫西林2.0 g/d,停药4周后复查12C尿素呼气试验,转阴性者判断为Hp根除,记录根除治疗前后血氨和脑电图情况.结果 Hp阳性者血氨水平83.04±20.81 mmol/L及脑电图异常发生率为86.1%,均明显高于Hp阴性者(P＜0.01＜);根除Hp后血氨水平49.10±9.80 mmol/L及脑电图异常发生率3.1%,均明显下降(P＜0.01).结论 Hp感染是引起肝硬化患者高血氨及脑电图异常的重要原因之一.根除Hp有助于治疗和预防肝性脑病.

Clinical Observation of Helicobacter Pylori Eradication on Blood Ammonia Concentration and Electroencephalogram in Cirrhotic Patients

Objective To observe the efficacy of helicobacter pylori(Hp)eradication on blood ammonia concentration and electroencephalogram in liver cirrhotic patients.Methods52 patients diagnosed with hepatic cirrhosis were enrolled.Hp was assessed by 14C-urea breath test or histological examination.The patients with Hp infection received one-week standard triple therapy(omerprazole 40 mg/d,clarithromycin 1.0 g/d,amoxicillin 2.0 g/d).14 C-urea breath test was performed 4 weeks later.If 14 C-urea test examination was n...