根除幽门螺杆菌对乙肝后肝硬化患者血氨的影响

目的探讨乙肝后肝硬化患者幽门螺杆菌(HP)感染与血氨的关系。方法选择160例HP阳性的乙型肝炎后肝硬化患者为阳性组,48例HP阴性的乙型肝炎后肝硬化患者为阴性组,83例HP阴性的健康检查者为对照组。分别检测各组的空腹血氨。阳性组病例治疗1周,停药4周后复查HP,根除HP后复查血氨。根据肝功能Child分级进行分组,比较各组血氨水平。结果阳性组血氨浓度显著高于阴性组(P<0.01);阴性组血氨浓度亦显著高于对照组(P<0.01);HP根除后血氨浓度显著下降(P<0.01);阳性组中不同肝功能分级组血氨浓度之间有显著差异(P<0.05),而阴性组中不同肝功能分级组血氨浓度之间无显著差异(P>0.05)。结论HP感染与乙肝后肝硬化的血氨浓度升高密切相关,易并发肝性脑病,根除HP可使血氨水平显著降低,有利于防治肝性脑病。

An influence on blood ammonia of posthepatitic cirrhosis after eradicating Helicobacter pylori

Objectives To study the relationship between Helicobacter pylori(HP)infection and the serum ammonia concentration in patients with liver cirrhosis.Methods HP positive group consisted of 160 liver cirrhotic patients after chronic hepatitis B with HP infection.HP negative group consisted of 48 liver cirrhotic patients after chronic hepatitis B without HP infection.Control group consisted of 87 healthy subjects.All the liver cirrhotic patients were re-divided into different grade groups according to Child's system.The blood ammonia concentration of each group were measured.In the HP positive group,the blood ammonia concentrationwas re-determined after HP eradication therapy.Results The blood ammonia concentration in HP positive group was significantly higher than that in the HP negative group(P<0.01),and it decreased markedly after HP eradication therapy.The blood ammonia concentration in HP negative groupwas significantly higher than that in the control group(P<0.01).In HP positive group,the blood ammonia concentration increased with increasing Child-Pugh grades from Ato C(P<0.05).Conclusion There is close correlation between HP infection and the blood ammonia concentration in liver cirrhotic patients.HP eradication lowers blood ammonia concentration and may be beneficial for preventing hepatic encephalopathy.