目的 观察是否根除幽门螺杆菌(Hp)对非酒精性脂肪性肝病(NAFLD)程度的影响。方法 2015年12月至2016年4月,选取本院诊断为NAFLD并发Hp感染的患者219例,取119例(观察组)行抗Hp四联治疗,停药1个月后复查13C尿素呼气试验,余100例为对照组。两组经6个月的综合康复治疗后行腹部彩超观察NAFLD的程度。结果 干预后,观察组Hp根除107例(90.68%),出现肺部感染中止治疗1例。观察组107例Hp根除患者NAFLD程度低于对照组(χ2=8.397, P<0.05)。结论 根除Hp并结合综合康复可改善NAFLD程度。
Objective To observe the effect of eradication of helicobacter pylori (Hp) combined with comprehensive rehabilitation treatment on patients with non-alcoholic fatty liver disease (NAFLD). Methods From December, 2015 to April, 2016, 219 patients diagnosed as NAFLD with Hp infection were enrolled, in which 119 patients (observation group) were treated with anti Hp quadruple therapy. They were tested with 13C urea breath test one month after drug withdrawal. The other 100 patients were as control group. The severity of NAFLD was observed with abdominal ultrasound after six months. Results After treatment, Hp was eradicated in 107 cases (90.68%) in the observation group, one dropped out for pulmonary infection. After six months, the severity of NAFLD improved better in the patients eradicated Hp in the observation group than in the control group (χ2=8.397, P<0.05). Conclusion Eradication of Hp combined with comprehensive rehabilitation treatment can improve the severity of NAFLD.
[1] 王素琴,黄缘. 非酒精性脂肪肝病的研究进展[J]. 世界华人消化杂志, 2014, 22(23): 3410-3415.
[2] Duan XY, Qiao L, Fan JG. Clinical features of nonalcoholic fatty liver disease-associated hepatocellular carcinoma [J]. Hepatobiliary Pancreat Dis Int, 2012, 11(1): 18-27.
[3] Bouziana SD, Tziomalos K. Inhibition of apoptosis in the management of nonalcoholic fatty liver disease [J]. World J Gastrointest Pharmacol Ther, 2013, 4(1): 4-8.
[4] Bremer AA, Mietus-Snyder M, Lustig RH. Toward a unifying hypothesis of metabolic syndrome [J]. Pediatrics, 2012, 129(3): 557-570.
[5] 郭云霞,王郁杰,朱莹. 幽门螺杆菌感染与胃癌的相关性探讨[J]. 中华医院感染学杂志, 2014, 24(7): 1700-1704.
[6] Pais R, Charlotte F, Fedchuk L, et al. A systematic review of follow-up biopsies reveals disease progression in patients with non-alcoholic fatty liver [J]. J Hepatol, 2013, 59(3): 550-556.
[7] 范建高,曾民德. 脂肪性肝病[M]. 2版. 北京:人民卫生出版社, 2013: 255.
[8] Li X, Xia M, Ma H, et al. Liver fat content, evaluated through semi-quantitative ultrasound measurement, is associated with impaired glucose profiles: a community-based study in Chinese [J]. PLoS One, 2013, 8(7): e65210.
[9] 章秋芳,王中英,徐建平. 非酒精性脂肪性肝病与冠状动脉粥样硬化相关性及冠脉病变特点分析[J]. 中国中西医结合消化杂志, 2016, 24(2): 112-115.
[10] 卢晓旭,卢学锋,邱敬涛,等. Hp感染与超声检测颈动脉粥样硬化程度和MMP-9及内脂素的相关性研究[J]. 中华医院感染学杂志, 2016, 26(22): 5141-5143.
[11] 朱秀芳,黄茜,杨湛南,等. 幽门螺杆菌感染与冠心病的关系[J]. 中国老年学杂志, 2016, 21(36): 5273-5275.
[12] Vafaeimanesh J, Hejazi SF, Damanpak V, et al. Association of Helicobacter pylori infection with coronary artery disease: is Helicobacter pylori a risk factor? [J]. Scientific World Journal, 2014, 2014: 516354.
[13] Polyzos SA, Kountouras J, Papatheodorou A, et al. Helicobacter pylori infection in patients with nonalcoholic fatty liver disease [J]. Metabolism, 2013, 62(1): 121-126.
[14] Li M, Shen Z, Li YM. Potential role of Helicobacter pylori infection in nonalcoholic fatty liver disease [J]. World J Gastroenterol, 2013, 19(41): 7024-7031.
[15] Takuma Y. Helicobacter pylori infection and liver diseases [J]. Gan To Kagaku Ryoho, 2011, 38(3): 362-364.
[16] Vcev A, Nakić D, Mrden A, et al. Helicobacter pylori infection and coronary artery disease [J]. Coll Antropol, 2007, 31(3): 757-760.
[17] 刘安楠,王蕾蕾,张晏,等. 非酒精性脂肪性肝病与幽门螺杆菌感染的相关性[J]. 胃肠病和肝胆病杂志, 2014, 23(12): 1451-1456.
[18] Korponay-Szabó IR, Halttunen T, Szalai Z, et al. In vivo targeting of intestinal and extraintestinal transglutaminase 2 by celiac autoantibodies [J]. Gut, 2004, 53(5): 641-648.
[19] Eshraghian A, Hashemi SA, Hamidian Jahromi A, et al. Helicobacter pylori infection as a risk factor for insulin resistance [J]. Dig Dis Sci, 2009, 54(9): 1966-1970.
[20] Naja F, Nasreddine L, Hwalla N, et al. Association of H. pylori infection with insulin resistance and metabolic syndrome among Lebanese adults [J]. Helicobacter, 2012, 17(6): 444-451.
[21] 范建高. 国内外非酒精性脂肪性肝病诊疗指南的异同[J]. 临床肝胆杂志, 2012, 28(7): 493-495.
