论文部分内容阅读
目的探讨肝硬化患者的幽门螺杆菌(Hp)感染情况并观察根除Hp后肝硬化患者血氨和脑电图的变化。方法确诊的肝硬化患者52例,经胃镜或14C尿素呼气试验明确Hp感染情况,对Hp阳性者进行Hp根除治疗(一周标准三联疗法),方案为奥美拉唑40mg/d,克拉霉素1.0g/d,阿莫西林2.0g/d,停药4周后复查14C尿素呼气试验,转阴性者判断为Hp根除,记录根除治疗前后血氨和脑电图情况。结果Hp阳性者血氨水平83.04±20.81mmol/L及脑电图异常发生率为86.1%,均明显高于Hp阴性者(P<0.01<);根除Hp后血氨水平49.10±9.80mmol/L及脑电图异常发生率3.1%,均明显下降(P<0.01)。结论Hp感染是引起肝硬化患者高血氨及脑电图异常的重要原因之一。根除Hp有助于治疗和预防肝性脑病。
Objective To investigate the prevalence of Helicobacter pylori (Hp) in cirrhotic patients and to observe the changes of serum ammonia and electroencephalogram in cirrhotic patients with Hp eradication. Methods Fifty-two patients with cirrhosis diagnosed by gastroscopy or 14C urea breath test were used to confirm the Hp infection. Hp eradication therapy (one week standard triple therapy) was given to Hp-positive patients. Omeprazole 40 mg / d, clarithromycin 1.0g / d, amoxicillin 2.0g / d, withdrawal 14 weeks after the withdrawal of 14C urea breath test, negative were judged as Hp eradication, eradication before and after treatment recorded blood ammonia and EEG situation. Results The blood ammonia level of Hp positive patients was 83.04 ± 20.81mmol / L and that of abnormal electroencephalogram was 86.1%, which was significantly higher than that of Hp negative patients (P <0.01). The blood ammonia level after Hp eradication was 49.10 ± 9.80mmol / L And the incidence of abnormal electroencephalogram 3.1%, were significantly decreased (P <0.01). Conclusion Hp infection is one of the important causes of abnormal ammonia and EEG in cirrhotic patients. Eradication of Hp helps to treat and prevent hepatic encephalopathy.