CAJ | 학술논문

目的：探讨不同方案幽门螺杆菌（Helicobacter pylori，Hp）感染的根除对Hp阳性的肝硬化患者血氨水平的影响。方法选择72例Hp阳性的肝硬化患者，随机分为2组，A组给予埃索美拉唑（20 mg，2次/d）加阿莫西林（1000 mg，2次/d）加左氧氟沙星（500 mg，1次/d），疗程10天。B组给予埃索美拉唑（20 mg，2次/d）加阿莫西林（1000 mg，2次/d）加甲硝唑（400 mg，2次/d），疗程10天。疗程结束4周后复查Hp，观察Hp根除率，并比较治疗前及停止根除Hp治疗后4周空腹血氨水平。结果（1）A组和B组的Hp根除率分别为91.7％和75.0％，A组HP根除率明显高于B组（P＜0.05）；（2）Hp根除治疗前，A组肝硬化患者的血氨水平为（82.8±8.1）μmol/L，B组肝硬化患者的血氨水平为（83.9±9.3）μmol/L，差异无统计学意义（P＞0.05）。Hp根除治疗后，A组肝硬化患者的血氨水平为（34.3±6.3）μmol/L，B组肝硬化患者的血氨水平为（48.7±7.4）μmol/L，A组肝硬化患者的血氨水平显著低于B组，差异有统计学意义（P＜0.05）。结论根除Hp治疗可以降低Hp阳性的肝硬化患者血氨水平，Hp根除率越高，血氨水平降低越明显，因而提高Hp根除率可能有助于预防和治疗Hp阳性的肝硬化肝性脑病的发生。
목적：탐토불동방안유문라간균（Helicobacter pylori，Hp）감염적근제대Hp양성적간경화환자혈안수평적영향。방법선택72례Hp양성적간경화환자，수궤분위2조，A조급여애색미랍서（20 mg，2차/d）가아막서림（1000 mg，2차/d）가좌양불사성（500 mg，1차/d），료정10천。B조급여애색미랍서（20 mg，2차/d）가아막서림（1000 mg，2차/d）가갑초서（400 mg，2차/d），료정10천。료정결속4주후복사Hp，관찰Hp근제솔，병비교치료전급정지근제Hp치료후4주공복혈안수평。결과（1）A조화B조적Hp근제솔분별위91.7％화75.0％，A조HP근제솔명현고우B조（P＜0.05）；（2）Hp근제치료전，A조간경화환자적혈안수평위（82.8±8.1）μmol/L，B조간경화환자적혈안수평위（83.9±9.3）μmol/L，차이무통계학의의（P＞0.05）。Hp근제치료후，A조간경화환자적혈안수평위（34.3±6.3）μmol/L，B조간경화환자적혈안수평위（48.7±7.4）μmol/L，A조간경화환자적혈안수평현저저우B조，차이유통계학의의（P＜0.05）。결론근제Hp치료가이강저Hp양성적간경화환자혈안수평，Hp근제솔월고，혈안수평강저월명현，인이제고Hp근제솔가능유조우예방화치료Hp양성적간경화간성뇌병적발생。
Objective To investigate the effect of Helicobacter pylori(Hp) infection eradication with different programs on blood ammonia levels in Hp positive cirrhotic patients.MethodsChoose 72 cases of the Hp positive patients with cirrhosis, randomly divided into 2 groups, group A was given esomeprazole (20 mg,2 times/d) and amoxicilin (1 000 mg,2 times/d) and levofloxacin (500 mg,1/d), treatment for 10 days. Group B was given esomeprazole(20 mg,2 times/d) and amoxicilin(1000 mg,2 times/d) and metronidazole (400 mg,2 times/d),treatment for 10 days.The end of the course of 4 weeks to review Hp,observe the Hp eradicate rate,and compare the treatment before and 4 weeks after stop Hp eradication therapy on an empty stomach blood ammonia level.Results (1)The eradication rate in group A cirrhotic patients and group B cirrhotic patients were 91.7% and 75.0% respectively. The eradication rate of group A was higher significantly than group B (P<0.05).(2)Before therapy of eradicating Hp, Blood ammonia levels in group A cirrhotic patients were (82.8±8.1)μmol/L and(83.9±9.3)μmol/L in group B, the difference had no statistical significance(P>0.05). After therapy of eradicating Hp, Blood ammonia levels in group A cirrhotic patients were (34.3±6.3)μmol/L and(48.7±7.4)μmol/L in group B, Blood ammonia levels in group A was lower significantly than group B (P<0.05).Conclusion HP eradication can reduce blood ammonia levels in Hp positive cirrhotic patients. The higher the eradication rate is, the lower the Blood ammonia levels wil be. Thus increasing the Hp eradication rate may be helpful in the prevention and treatment of Hepatic encephalopathy in Hp positive cirrhotic patients.