Hp根治治疗对非酒精性脂肪性肝病患者血清细胞因子和血脂水平的影响

目的 研究幽门螺杆菌(Hp)根治治疗对Hp阳性的非酒精性脂肪性肝病(NAFLD)患者血清炎性因子和脂质代谢的影响。方法 2015年6月～2019年6月我院收治的168例Hp阳性的NAFLD患者,采用随机数字表法分为两组,每组84例。给予对照组多烯磷脂酰胆碱胶囊和二甲双胍联合治疗,观察组在对照组治疗的基础上行标准的Hp根治治疗。采用放射免疫法测定血清肿瘤坏死因子α(TNF-α)水平,采用比色法测定血清超敏C反应蛋白(hs-CRP)水平,采用ELISA法测定白介素6(IL-6)和IL-8水平。采用放射免疫法测定空腹胰岛素(FINS),计算胰岛素抵抗指数(HOMA-IR)。结果 在根治治疗1个月后,观察组Hp根除率为94.0%,而对照组无Hp转阴病例(P＜0.05);治疗后,观察组血清TNF-α水平为(12.6±2.5)ng/L,显著低于对照组【(28.6±5.5)ng/L,P＜0.05】,血清hs-CRP水平为(7.5±1.4)mg/L,显著低于对照组【(14.6±2.6)mg/L,P＜0.05】,血清IL-6水平为(12.5±2.3)ng/L,显著低于对照组【(29.6±5.4)ng/L,P＜0.05】,和血清IL-8水平为(80.4±23.7)ng/L,显著低于对照组【(145.2±38.1)ng/L,P＜0.05】;观察组TC为(3.1±0.9)mmol/L,显著低于对照组【(4.8±0.7)mmol/L,P＜0.05】,TG为(1.5±0.8)mmol/L,显著低于对照组【(2.9±0.7)mmol/L,P＜0.05】,LDL-C为(0.9±0.4)mmol/L,显著低于对照组【(1.7±0.5)mmol/L,P＜0.05】,而HDL-C为(2.4±0.3)mmol/L,显著高于对照组【(1.8±0.4)mmol/L,P＜0.05】;观察组FINS为(16.0±5.2)μIU/ml,显著低于对照组【(19.0±6.4)μIU/ml,P＜0.05】,HOMA-IR为(3.9±2.4),显著低于对照组【(4.4±3.1),P＜0.05】。结论 根治Hp治疗对降低Hp阳性的NAFLD患者血清炎性因子水平、纠正糖脂代谢紊乱和改善肝功能具有重要的作用。

Effect of radical therapy forHelicobacter pylori on serum inflammatory factors and lipid metabolism in patients with Hp positive non-alcoholic fatty liver disease

Objective The aim of this study was to investigate the effect of radical treatment of Helicobacter pylori(Hp)on serum inflammatory factors and lipid metabolism in patients with Hp-positive nonalcoholic fatty liver disease(NAFLD).Methods 168 patients with Hp-positive NAFLD were enrolled to our hospital between June 2015 and June 2019,and were divided randomly into two groups,with 84 cases in each.The patients in control group received polyene phosphatidylcholine and metformin,while those in the observation group received standardized therapy for Hp eradication at the base of treatments in the control.Serum levels of tumor necrosis factor-alpha(TNF-alpha),hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6)and IL-8 were assayed,and fasting blood glucose(FPG),fasting insulin(FINS)and insulin resistance index(HOMA-IR)were also detected.Results At the end of one month after radical therapy,the eradication rate of Hp in the observation group was 94.0%,while no negative cases of Hp was found in the control(P<0.05);serum TNF-alpha in the observation group was(12.6±2.5)ng/L,significantly lower than(28.6±5.5)ng/L,P<0.05)],hs-CRP was(7.5±1.4)mg/L,significantly lower than(14.6±2.6)mg/L,P<0.05)],IL-6 was(12.5±2.3)ng/L,significantly lower than(29.6±5.4)ng/L,P<0.05]and serum IL-8 was(80.4±23.7)ng/L,significantly lower than(145.2±38.1 ng/L,P<0.05]in the control;blood total cholesterol level in the observation group was(3.1±0.9)mmol/L,significantly lower than(4.8±0.7)mmol/L,P<0.05],blood triglyceride was(1.5±0.8)mmol/L,significantly lower than(2.9±0.7)mmol/L,P<0.05],blood low density lipoprotein cholesterol was(0.9±0.4)mmol/L,significantly lower than(1.7±0.5)mmol/L,P<0.05],while blood high density lipoprotein cholesterol level was(2.4±0.3)mmol/L,significantly higher than【(1.8±0.4)mmol/L,P<0.05】in the control;serum FINS level in the observation group was(16.0±5.2)uIU/ml,significantly lower than(19.0±6.4)uIU/ml,P<0.05],and HOMA-IR was(3.9±2.4),significantly lower than(4.4±3.1,P<0.05]in the control.Conclusion Radical treatment of Hp might play an important role in reducing blood inflammatory factors,correcting the disorder of glycolipid metabolism and improving liver functions in Hp-positive NAFLD patients.