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目的研究胃内pH值对肝硬化伴幽门螺杆菌(Hp)感染患者血氨的影响。方法对37例Hp阳性的肝硬化患者及40例Hp阴性的肝硬化患者,测定基础血氨后,静脉注奥美拉唑针40mg,同时动态监测胃内pH值的变化,待胃内pH>6且持续1h后,复测血氨。结果Hp阴性与阳性肝硬化患者的基础血氨水平差异无显著性(P>0.05)。胃内pH升高后,发现Hp阴性的肝硬化患者及Hp阳性的肝硬化ChildPughA级患者,血氨水平与实验前差异无显著性(P>0.05)。Hp阳性的肝硬化ChildPughB、ChildPughC级患者血氨水平较前明显升高,分别由26.33±6.49μmol/L、35.30±10.25μmol/L升高至35.80±6.25μmol/L、52.20±17.01μmol/L,差异有非常显著性意义(P<0.01)。结论肝功能状况和胃内pH值是影响Hp感染肝硬化患者血氨水平的两个重要因素。
Objective To study the effect of intragastric pH on serum ammonia in patients with cirrhosis and Helicobacter pylori (Hp) infection. Methods Thirty-seven Hp-positive cirrhotic patients and 40 Hp-negative cirrhotic patients were enrolled in this study. After basal blood ammonia was measured, 40 mg of omeprazole was intravenously injected. At the same time, the changes of gastric pH were monitored dynamically. When the intragastric pH> 6 and continued 1h, retest blood ammonia. Results There was no significant difference in basal ammonia level between Hp negative and positive cirrhotic patients (P> 0.05). After the intragastric pH was increased, there was no significant difference in blood ammonia levels between Hp-negative cirrhosis patients and Hp-positive cirrhosis Child Pugh class A patients (P> 0.05). Blood ammonia levels in Childpugh and Childpuff patients with Hp positive cirrhosis were significantly higher than those in the previous groups, from 26.33 ± 6.49μmol / L and 35.30 ± 10.25μmol / L to 35.80 ± 6.25μmol / L, 52.20 ± 17.01μmol / L , The difference was very significant (P <0.01). Conclusions Liver function and intragastric pH are two important factors that affect the level of ammonia in patients with Hp infection.