肝硬化合并幽门螺杆菌感染患者血氨测定的临床意义

Clinical significance of the test in serum ammonia concentration in liver cirrhosis with helicobacter pylori infection

目的探讨肝硬化患者合并幽门螺杆菌(Hp)感染后血氨浓度变化与不同肝功能分级的关系,观察根除Hp后对血氨的影响。方法49例确诊为Hp阳性的肝硬化患者为阳性组,46例Hp阴性的肝硬化患者为阴性组,40例Hp阳性的正常人为对照组,分别检测三组血氨浓度并进行比较。应用阿莫西林、克拉霉素、替硝唑治疗1周,于4周后再次检测三组血氨浓度并进行比较。结果阳性组血氨浓度与阴性组、对照组比较差异有统计学意义(P<0.05);阴性组与对照组比较差异无统计学意义(P>0.05)。阳性组不同肝功能分级血氨浓度比较差异有统计学意义(P<0.01),治疗后三组的血氨浓度差异无统计学意义(P>0.05)。结论Hp感染与肝硬化血氨浓度密切相关,根除Hp可以使血氨水平显著下降。

Objective To study the relationship between ammonia concentration levels,Child class in cirrhotic patients with helicobacter pylori（Hp） infection and to observe the Hp eradication effect on ammonia. Methods Group A was consisted of 49 cases of cirrhotic patients with Hp infection. Group B included 46 cirrhotic patients without Hp infection. Group C was non-cirrhotic patients with helicobacter pylori infection. Each patient in all three groups was compared with change in serum ammonia concentration before and 4 weeks after Hp eradication therapy. Results The serum ammonia concentration in group A was significantly higher than group B and group C（ P 〈 0.05）. While there was no difference between group B and group C（ P 〉 0.05 ）. In group A, the serum ammonia concentration was increased as Child classification from A to C（ P 〈 0.01 ）. The serum ammonia concentration in three groups was no different 4 weeks after Hp eradication therapy. Conclusion There is a relation between Hp infection and the serum ammonia concentration in cirrhosis patients. The serum ammonia concentration is decreased after Hp eradication.