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幽门螺杆菌根除对因不明原因高转氨酶血症前来就诊患者肝脏酶的影响。

The effect of Helicobacter pylori eradication on liver enzymes in patients referring with unexplained hypertransaminasemia.

作者信息

Salehi Hassan, Minakari Mohammad, Yaghoutkar Arezoo, Tabesh Elham, Salehi Marziyeh, Mirbagher Leila

机构信息

Department of Infectious Diseases, Isfahan University of Medical Sciences, Isfahan, Iran.

Department of Internal Medicine, Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Adv Biomed Res. 2014 May 28;3:131. doi: 10.4103/2277-9175.133256. eCollection 2014.

Abstract

BACKGROUND

Evidence has shown an association of Helicobacter pylori infection with liver dysfunction and damage. We investigated if H. pylori eradication affects liver enzymes in patients referring with unexplained hypertransaminasemia.

MATERIALS AND METHODS

Patients with mild unexplained hypertransaminasemia accompanied with dyspepsia and confirmed H. pylori infection were studied. Viral, metabolic, autoimmune, and drug/toxin induced hepatitis as well as fatty liver were all ruled-out by appropriate tests. Patients received bismuth-containing quadruple-therapy for 2 weeks. Serum levels of liver enzymes (alanine transaminase (ALT) and aspartate transaminase (AST)) and successful eradication (with stool antigen test) were evaluated 4 weeks after the medication.

RESULTS

A total number of 107 patients (55 males, mean age = 35.0 ± 8.4 years) were studied. Eradication was successful in 93 patients (86.9%). Serum levels of AST (6.3 ± 19.6 IU/L, P = 0.002) and ALT (7.8 ± 24.9 IU/L, P = 0.001) were significantly decreased after eradication. Levels of AST and ALT decreased to normal range respectively in 46.6% and 45.7% of the cases who had baseline levels above the normal range.

CONCLUSION

This study showed a decrease in liver enzymes after receiving eradication regimen of H. pylori, suggesting a role for H. pylori infection in at least some of patients with mild unexplained hypertransaminasemia. Further studies are warranted to find the underlying mechanisms by which H. pylori infection affects the liver and clinical importance of such effects.

摘要

背景

有证据表明幽门螺杆菌感染与肝功能障碍及损害有关。我们调查了幽门螺杆菌根除治疗对因不明原因高转氨酶血症前来就诊的患者肝脏酶的影响。

材料与方法

对伴有消化不良且确诊为幽门螺杆菌感染的轻度不明原因高转氨酶血症患者进行研究。通过适当检测排除病毒、代谢、自身免疫、药物/毒素所致肝炎以及脂肪肝。患者接受含铋四联疗法治疗2周。用药4周后评估肝脏酶(丙氨酸转氨酶(ALT)和天冬氨酸转氨酶(AST))的血清水平以及根除治疗是否成功(采用粪便抗原检测)。

结果

共研究了107例患者(55例男性,平均年龄 = 35.0 ± 8.4岁)。93例患者(86.9%)根除治疗成功。根除治疗后AST(6.3 ± 19.6 IU/L,P = 0.002)和ALT(7.8 ± 24.9 IU/L,P = 0.001)的血清水平显著降低。基线水平高于正常范围的患者中,分别有46.6%和45.7%的患者AST和ALT水平降至正常范围。

结论

本研究显示接受幽门螺杆菌根除治疗后肝脏酶水平降低,提示幽门螺杆菌感染在至少部分轻度不明原因高转氨酶血症患者中起作用。有必要进一步研究幽门螺杆菌感染影响肝脏的潜在机制以及这种影响的临床重要性。

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