幽门螺杆菌感染与肝性脑病的相关性

摘要

目的 探讨肝硬化患者幽门螺杆菌(H.pylori)感染和肝性脑病(HE)发病的相关性.方法 收集110例符合诊断标准的肝硬化患者,详细记录H.pylori检测结果、血氨水平、数字连接试验(NCT)结果、HE临床症状.其中71例H.pylori阳性者随机分为观察组和对照组,观察组予泮托拉唑钠肠溶胶囊+克拉霉素缓释片+奥硝唑胶囊进行根除治疗,1周后复查血氨.结果 H.pylori阳性肝硬化患者的血氨水平及HE的发生率明显高于H.pylori阴性的肝硬化患者,两者差异有统计学意义(P＜0.05)；H.pylori阳性者中观察组行H.pylori根除治疗,血氨下降明显优于对照组(P＜0.05).结论 H.pylori感染可使肝硬化患者血氨水平升高,根除H.pylori治疗对降低肝性脑病的发生有重要的临床意义.%Objective To discuss the relationship between Helicobacter pylori (H. pylori) infection and hepatic en-cephalopathy (HE). Methods The data of the H. pylori examination, blood ammonia, number connection test (NCT) and hepatic encephalopathy (HE) were collected in 110 cases who meet the standards of liver cirrhosis. 71 patients with H. pylori-positive were randomly divided into two groups, and experimental group was given one week therapy with pan-toprazole plus clarithromycin and ornidazole. After one week, blood ammonia concentration was reexamined. Results Compared with H. pylori-negtive of cirrhotic patients, the level of blood ammonia and the rate of HE were significantly higher in H. pylori-positive patients (P<0.05). The blood ammonia concentration in experimental group with H. pylori eradication therapy was lower apparently than that in control group (P <0.05). Conclusion H. pylori infection may raise the level of blood ammonia in liver cirrhotic patients, and H. pylori eradication has significant clinical meaning in decreasing the rate of HE.