NAFLD合并Hp感染患者清除治疗前后血清细胞因子水平变化*

doi:10.3969/j.issn.1672-5069.2021.04.012

摘要/Abstract

摘要： 目的研究非酒精性脂肪性肝病(NAFLD)合并幽门螺杆菌(Hp)感染患者在根除治疗后血清细胞因子和肝功能指标的变化。方法 2018年10月～2020年10月我院诊治的84例NAFLD合并Hp感染患者,被随机分为观察组42例和对照组42例,两组均采取饮食控制和运动疗法,给予观察组患者四联清除Hp治疗2 w。采用ELISA法检测血清白介素(IL)-6、IL-18和肿瘤坏死因子(TNF)-α水平。计算胰岛素抵抗指数(HOMA-IR)。结果观察组清除Hp治疗后治愈24例,显效10例,有效8例;治疗后,观察组血清IL-6、IL-18和TNF-α水平分别为(23.4±8.0)pg/ml、(43.7±8.2)pg/ml和(1.5±0.4)ng/L,显著低于对照组【分别为(30.6±6.8)pg/ml、(49.5±10.1)pg/ml和(1.7±0.5)ng/L,P<0.05】; 两组血清AST水平分别为(50.8±10.9)U/L 对 (48.1±9.9)U/L,血清ALT水平分别为(69.3±13.5)U/L对(71.8±8.7)U/L,血清GGT水平分别为(84.8±16.7)U/L 对(86.2±20.3)U/L,均无统计学差异(P>0.05);观察组HOMA-IR为(2.3±1.1),显著低于对照组【(3.3±1.2),P <0.05】,而空腹血糖和餐后2小时血糖水平分别为(6.3±1.0)mmol/L和7.3±0.9)mmol/L,与对照组的(6.5±0.8)mmol/L和(7.9±1.1)mmol/L比,无统计学差异(P >0.05);两组血脂水平比较,也无统计学差异(P >0.05)。结论根除Hp治疗可以短期抑制NAFLD患者炎性反应,其对于肝功能和血脂水平的影响可能需要长期观察。

关键词: 非酒精性脂肪性肝病, 幽门螺杆菌感染, 细胞因子, 根除治疗

Abstract: Objective The aim of this study was to investigate serum cytokine changes in patients with nonalcoholic fatty liver diseases (NAFLD) and helicobacter pylori (HP)infection after clearance therapy. Methods 84 patients with NAFLD and HP infection were enrolled in our hospital between October 2018 and October 2020, and were randomly divided into observation and control group with 42 cases in each group. All patients received diet-control and exercise guidance, and those in the observationgroup received conventional four medicine combination for Hp eradication. Serum IL-6, IL-18 and TNF-α levels were detected by ELISA, and the homeostasis model assessment of insulin resistance index (HOMA-IR) was calculated. Results The Hp infection was eradicated in all patients in the observation group; after treatment, serum IL-6,IL-18 and TNF-α levels in the observation group were (23.4±8.0)pg/ml, (43.7±8.2)pg/ml and (1.5±0.4)ng/L, all significantly lower than [(30.6±6.8)pg/ml, (49.5±10.1)pg/ml and (1.7±0.5)ng/L, respectively, P<0.05] in the control; there were no significantly differences as respect to serum AST levels [(50.8±10.9)U/L vs. (48.1±9.9)U/L], serum ALT levels [(69.3±13.5)U/L vs. (71.8±8.7)U/L] and serum GGT levels [(84.8±16.7)U/L vs. (86.2±20.3)U/L] between the two groups (P>0.05); the HOMA-IR in the observation group was (2.3±1.1), significantly lower than [(3.3±1.2), P <0.05] in the control, while there were no significant differences respect to fasting blood glucose levels [(6.3±1.0)mmol/L vs. (6.5±0.8)mmol/L] and blood glucose level at two hour after meal [7.3±0.9)mmol/L vs. (7.9±1.1)mmol/L] between the two groups(P >0.05); there was no significant difference in blood ester between the two groups(P >0.05). Conclusion The eradication of HP infection could inhibit inflammatory reaction in patients with NAFLD and HPinfection, which warrants further investigation for its impact on hepatic steatosis.

Key words: Nonalcoholic fatty liver diseases, Helicobacter pylori infection, Cytokines, Eradication therapy

张佳, 晋明渊, 杜艳云, 胡秀娟, 王烈姣. NAFLD合并Hp感染患者清除治疗前后血清细胞因子水平变化^*[J]. 实用肝脏病杂志, 2021, 24(4): 500-503.

Zhang Jia, Jin Mingyuan, Du Yanyun, et al. Serum cytokine changes in patients with nonalcoholic fatty liver diseases and helicobacter pylori infection after clearance therapy[J]. Journal of Practical Hepatology, 2021, 24(4): 500-503.

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NAFLD合并Hp感染患者清除治疗前后血清细胞因子水平变化^*

Serum cytokine changes in patients with nonalcoholic fatty liver diseases and helicobacter pylori infection after clearance therapy

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