幽门螺杆菌感染对肝硬化患者血氨水平的影响

Study of Correlation between Helicobacter Pylori Infection and Hyperamonemia in Cirrhotic Patients

目的探讨幽门螺杆菌(H.pylori)感染对肝硬化患者血氨水平的影响。方法将79例肝硬化患者分为H.pylori阳性组和H.pylori阴性组,均给予H.pylori根除治疗1周,比较治疗前及停止根除H.pylori治疗后4周患者的空腹血氨水平。结果 (1)79例肝硬化患者中H.pylori阳性者54例,H.pylori感染率为68.3%;(2)肝硬化H.pylori阳性者的血氨水平为(82.8±8.1)μmol/L,显著高于肝硬化H.pylori阴性者的(40.7±7.3)μmol/L,差异有统计学意义(P<0.01);(3)H.pylori阳性组中39例患者治疗后H.pylori根除,患者治疗前、后的血氨水平为(86.9±9.3)μmol/L和(37.3±7.8)μmol/L,二者差异有统计学意义(P<0.01)。而H.pylori阴性组患者抗H.pylori治疗前、后血氨水平〔(40.7±7.3)μmol/L与(39.3±8.1)μmol/L〕比较,差异无统计学意义(P>0.05)。结论 H.pylori感染可加重肝硬化患者的高氨血症,根除H.pylori治疗可以降低血氨水平,有助于预防和治疗肝硬化肝性脑病的发生。

Objective To investigate the effect of helicobacter pylori（H.pylori） infection on blood ammonia level in cirrhotic patients.Methods 79 cirrhotic patients were divided into H.pylori positive group and H.pylori negative group,who were given one week therapy of eradicating H.pylori,then compared the level of blood ammonia before therapy and after therapy with 4 weeks.Results（1）H.pylori positive patients were 54 in all 79 cirrhotic patients,H.pylori infection rate was 68.3%.（2）Blood ammonia levels in H.pylori positive and H.pylori negative cirrhotic patients were（82.8±8.1）μmol/L and（40.7±7.3）μmol/L,the difference had statistical significance（P0.01）.（3）In H.pylori positive group,H.pylori of 39 patients were eradicated after therapy,blood ammonia levels before and after therapy were（86.9±9.3）μmol/L and（37.3±7.8）μmol/L,the difference had statistical significance（P0.01）.However in H.pylori negative group,blood ammonia levels before and after therapy were（40.7±7.3）μmol/L and（39.3±8.1）μmol/L,the difference had no statistical significance（P0.05）.Conclusion H.pylori infection aggravates elevated blood ammonia concentration in cirrhotic patients,H.pylori eradication can reduce blood ammonia level,which may be helpful in the prevention and treatment of hepatic encephalopathy in cirrhotic patients.