根除幽门螺杆菌对非酒精性脂肪性肝病的影响

发布时间：2018-08-11 12:16

【摘要】：目的评价根除幽门螺杆菌(Hp)感染对非酒精性脂肪性肝病(NAFLD)患者的影响,为临床防治提供依据。方法选取2012年1月-2013年9月诊断为Hp感染的154例NAFLD患者进行抗Hp三联治疗(泮托拉唑40.0 mg+阿莫西林1.0 g+克拉霉素0.5 g,2次/d,疗程2周),停药1个月后复查14C尿素呼气试验,分为Hp根除组和Hp未根除组,分别比较每组治疗前后血清丙氨酸氨基转移酶(ALT)、总胆固醇(TC)、三酰甘油(TG),空腹血糖(FBG)水平及计算稳态模型的胰岛素抵抗指数(HOMA-IR)。采用SPSS 10.0统计学软件进行数据分析。结果 154例NAFLD患者中89例Hp根除,65例Hp未根除,Hp感染根除率为57.79%。Hp根除组治疗后HOMA-IR较治疗前显著降低,差异有统计学意义(P0.05),而治疗后ALT、TC、TG及FBG水平与治疗前比较,差异无统计学意义(P0.05);Hp未根除组治疗前后ALT、TC、TG、FBG水平及HOMA-IR比较,差异无统计学意义(P0.05)。结论根除Hp感染能够改善NAFLD患者的胰岛素抵抗(IR)状态,但不影响NAFLD患者肝功能、血脂及血糖水平。
[Abstract]:Objective to evaluate the effect of eradication of Helicobacter pylori (Hp) infection on (NAFLD) patients with nonalcoholic fatty liver disease. Methods 154 patients with NAFLD diagnosed as HP infection from January 2012 to September 2013 were treated with anti-HP triple therapy (pantazol 40.0 mg amoxicillin 1.0 g clarithromycin 0.5 g / d for 2 d, course of treatment 2 weeks). The 14C urea breath test was reexamined after one month's withdrawal. Serum alanine aminotransferase (ALT), total cholesterol (TC),) triglyceride (TG), fasting blood glucose (FBG) and insulin resistance index (HOMA-IR) were calculated in each group before and after treatment. The data were analyzed by SPSS 10.0 software. Results among the 154 patients with NAFLD, the eradication rate of HP infection in 65 cases without HP eradication was significantly lower in 57.79%.Hp eradication group than that before treatment (P0.05), and the levels of alt TCTG and FBG after treatment were compared with those before treatment. There was no significant difference between the two groups before and after treatment (P0.05). There was no significant difference in the level of TGBG and HOMA-IR before and after treatment (P0.05). Conclusion the eradication of HP infection can improve the (IR) status of insulin resistance in patients with NAFLD, but it does not affect liver function, blood lipid and blood glucose levels in NAFLD patients.
【作者单位】：华中科技大学同济医学院附属普爱医院消化内科;华中科技大学同济医学院附属普爱医院超声诊断科;
【基金】：武汉市卫生局临床科研项目(No:WX12C33)
【分类号】：R575

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