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目的探讨幽门螺杆菌(Helicobacter pylori,Hp)感染与非酒精性脂肪肝(nonalcoholic fatty liver disease,NAFLD)的关系。方法选取笔者医院2009年2月~2013年10月门诊及住院的受试者共250例分为两组,非酒精性脂肪肝组(A组)150例及健康对照组(B组)100例,通过13C-尿素呼气试验(13C-urea breath test,13C-UBT)检测受试者13C同位素丰度,根据其结果计算超基准值(delta over base line,DOB),判断其Hp感染情况。同时测定胰岛素、高敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、血脂系列,计算胰岛素抵抗指数(insulin resistance index,IRI),并对相关数据进行对比分析。结果两组Hp总感染率为57.6%,NAFLD组Hp感染率为68.7%,明显高于对照组41%(P<0.01);脂肪肝组DOB值,hs-CRP,IRI明显高于对照组(P<0.01),其中DOB值与hs-CRP,IRI呈正相关;Logistic多元回归分析显示,DOB值、IRI、hs-CRP、甘油三酯(TG)与NAFLD密切相关。结论 Hp感染是NAFLD的危险因子,其与胰岛素抵抗及hs-CRP密切相关。
Objective To investigate the relationship between Helicobacter pylori (Hp) infection and nonalcoholic fatty liver disease (NAFLD). Methods A total of 250 outpatients and hospitalized patients in our hospital from February 2009 to October 2013 were divided into two groups: 150 in non-alcoholic fatty liver group (A group) and 100 in healthy control group (B group) 13C-urea breath test (13C-UBT) was used to detect 13C isotope abundance. Based on the results, delta over base line (DOB) was calculated to determine Hp infection. The insulin, high-sensitivity C-reactive protein (hs-CRP), lipids and insulin resistance index (IRI) were measured at the same time, and the relative data were analyzed comparatively. Results The overall infection rate of Hp was 57.6% in both groups, and the Hp infection rate in NAFLD group was 68.7%, significantly higher than that in control group (P <0.01). The DOB value, hs-CRP and IRI in fatty liver group were significantly higher than those in control group P <0.01). There was a positive correlation between DOB value and hs-CRP and IRI. Logistic multiple regression analysis showed that DOB value, IRI, hs-CRP and triglyceride were closely related to NAFLD. Conclusion Hp infection is a risk factor for NAFLD, which is closely related to insulin resistance and hs-CRP.