根除幽门螺杆菌对肝硬化高氨血症影响

Effect of H pylori infection and its eradication on hyperammonemia in cirrhotic patients

目的观察幽门螺杆菌(Hp)感染与肝硬化患者高氨血症的关系。方法 14C-尿素呼气试验(14C-UBT)对84例肝硬化患者行幽门螺杆菌检测,并同时检测患者外周血血氨水平。对Hp阳性者给予根除治疗后复查血氨,比较Hp阳性和Hp阴性肝硬化患者血氨水平以及Hp阳性患者根除Hp前后血氨变化。结果 84例肝硬化患者Hp感染率为62.5%,61例Hp阳性者与23例Hp阴性者血氨水平分别(103.5±29.2)μmol/L和(84.7±25.3),差异有统计学意义(P<0.01)。Hp阳性肝硬化患者在根除Hp后血氨水平为(75.5±21.7)μmol/L,与根除前相比差异有统计学意义(P<0.01)。结论 Hp感染可导致肝硬化患者血氨升高,根除Hp后可使血氨水平下降。

Objective To investigate the relationship between H pylori infection, blood ammonia concentration and the effect of H pylori eradication in cirrhotic patients. Methods 84 cirrhotic patients were enrolled. Patients were evaluated for H pylori infection with(14)C urea breath test, blood ammonia concentration. Blood ammonia level were reassessed after H pylori eradication. Results Overall H pylori infection rate was 62.5%, Blood ammonia concentration in H pylori negative(n = 23) and positive(n = 61) cirrhotic patients was 84.7 +/- 25.3 and 103.5 +/- 29.2 umol/L, respectively(P < 0.01), which was significantly reduced to 75.5 +/- 21.7 umol/L after H pylori eradication(n = 50)(P < 0.01).Conclusion H pylori infection is an important factor for inducing high blood ammonia concentration in cirrhotic patients. H pylori eradication may be helpful for reducing blood ammonia concentration and prevention of HE.