42例肝硬化患者根除幽门螺杆菌治疗后血氨浓度的变化

Effect on Hyperammonaemia after Eradication Therapy of Helicobacter Pylori Infection in 42 Patients with Liver Cirrhosis

目的探讨幽门螺杆菌(Hp)感染对肝硬化患者血氨浓度的影响以及根除后血氨的变化。方法65例肝硬化高血氨患者分为Hp阳性组42例,阴性组23例。两组都给予口服乳果糖15mg,tid,一般治疗5d,治疗前后分别测空腹静脉血氨。随后将Hp阳性组随机分两组,A组21例,给予奥美拉唑20mg,阿莫西林1.0g,替硝唑1.0g;B组21例,给予奥美拉唑20mg,A、B两组药物用法均为po,bid,疗程2周。治疗结束及停药1个月后测空腹静脉血氨。结果肝硬化Hp阳性组血氨浓度(103.4±9.1)μmol·L-1,明显高于Hp阴性组血氨浓度(80.6±9.7)μmol·L-1(P<0.05)。Hp阳性A组根除Hp治疗后血氨(55.6±18.9)μmol·L-1,Hp阳性B组治疗后血氨(103.8±15.4)μmol·L-1,A、B两组比较差异有极显著性(P<0.01)。结论Hp感染能导致肝硬化患者血氨升高,可能为肝性脑病的诱因之一。根除Hp治疗能有效降低血氨,应得到重视。

Objective To study the effects on hyperammonaemia after eradication therapy of Helieobacter pylon （tip） infection in patients with liver cirrhosis. Methods Ammonia concentrations in blood were examined. Among 65 patients with liver cirrhosis,42 cases were positive of helicobacter pylori and 23 negative. The cases of Hp positive were divided into group A and B. Patients in group A were treated with anti-Hp drugs. Data of ammonia were analysed after eradication of Hp. Results Ammonia in patients with Hp positive liver cirrhosis was significantly higher than that in patients with Hp negative liver cirrhosis. Ammonia after eradication of Hp in group A was significantly lower than that in group B. Conclusion Helicobacter pylori infection could induce hyperammonia in patients with liver cirrhosis which may be one of the factors to induce hepatic encephalopathy. The eradication of helicobacter pylori is effective to lower blood ammonia in patients with liver cirrhosis hyperammonia,