85例肝硬化患者根除幽门螺杆菌治疗后血氨浓度的改变

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.方法85例肝硬化患者分为Hp阳性组62例,阴性组23例.两组都给予口服乳果糖15 mg/次,3次/d,一般治疗5 d,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31例,给予奥美拉唑20 mg,阿莫西林1.0 g,替硝唑1.0 g;B组31例,给予奥美拉唑20 mg.A,B两组药物用法均为口服,2次/d,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阳性组血氨浓度为(104.4±8.2)μmol.L-1,明显高于Hp阴性组的血氨浓度(81.7±7.5)μmol.L-1(P<0.05).Hp阳性A组根除Hp治疗后血氨浓度为(54.9±10.2)μmol.L-1,A,B两组比较差异具有显著性(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.

Effect on Hyperammonaemia after Eradication Therapy of Helicobacter Pylori Infection in 85 Patients with Liver Cirrhosis

Objective To study the effects on hyperammonaemia after eradication therapy of Helicobacter pylori(Hp) infection in patients with liver cirrhosis.Methods Ammonia concentration in blood were examined.Among 85 patients with liver cirrhosis,62 cases were positive of Helicobacter pylori and 31 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.