Polyzos Stergios A, Nikolopoulos Panagiotis, Stogianni Angeliki, Romiopoulos Iordanis, Katsinelos Panagiotis, Kountouras Jannis
Second Medical Clinic, Medical School, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Macedonia, Greece.
Department of Radiology, 424 General Military Hospital, Thessaloniki, Macedonia, Greece.
Arq Gastroenterol. 2014 Jul-Sep;51(3):261-8. doi: 10.1590/s0004-28032014000300017.
Limited clinical data suggest Helicobacter pylori (Hp) infection may contribute to nonalcoholic fatty liver disease (NAFLD) pathogenesis.
The effect of Hp eradication on hepatic steatosis (magnetic resonance imaging), nonalcoholic fatty liver disease fibrosis score and HSENSI (Homocysteine, serum glutamic oxaloacetic transaminase, Erythrocyte sedimentation rate, nonalcoholic steatohepatitis Index) in nonalcoholic steatohepatitis patients.
Thirteen adult patients with biopsy-proven nonalcoholic steatohepatitis, asymptomatic for gastrointestinal disease, underwent 13C urea breath test; Hp positive patients received eradication therapy until repeat test become negative. Hepatic fat fraction, standard biochemical tests and calculation of nonalcoholic fatty liver disease fibrosis score and HSENSI were performed at baseline and month 12.
Hepatic fat fraction was similar for between and within group comparisons. Nonalcoholic fatty liver disease fibrosis score showed a non-significant trend towards decrease in Hp(+) [-0.34 (-1.39-0.29) at baseline and -0.24 (-0.99-0.71) at month 12; P = 0.116], whereas increase in Hp(-) group [-0.38 (-1.72-0.11) and -0.56 (-1.43-0.46), respectively; P = 0.249]. HSENSI was significantly decreased only in Hp(+) group [1.0 (1.0-2.0) at baseline and 1.0 (0-1.0) at month 12; P = 0.048].
Hp eradication had no long-term effect on hepatic steatosis, but showed a trend towards improvement in nonalcoholic fatty liver disease fibrosis score and HSENSI. These results warrant larger studies with paired biopsies.
有限的临床数据表明，幽门螺杆菌（Hp）感染可能与非酒精性脂肪性肝病（NAFLD）的发病机制有关。
研究根除Hp对非酒精性脂肪性肝炎患者肝脂肪变性（磁共振成像）、非酒精性脂肪性肝病纤维化评分及HSENSI（同型半胱氨酸、血清谷氨酸草酰乙酸转氨酶、红细胞沉降率、非酒精性脂肪性肝炎指数）的影响。
13例经活检证实为非酒精性脂肪性肝炎且无胃肠道疾病症状的成年患者接受了13C尿素呼气试验；Hp阳性患者接受根除治疗，直至复查试验转为阴性。在基线和第12个月时进行肝脏脂肪分数、标准生化检查以及非酒精性脂肪性肝病纤维化评分和HSENSI的计算。
组间和组内比较的肝脏脂肪分数相似。非酒精性脂肪性肝病纤维化评分在Hp阳性组呈非显著下降趋势[基线时为-0.34（-1.39 - 0.29），第12个月时为-0.24（-0.99 - 0.71）；P = 0.116]，而Hp阴性组呈上升趋势[分别为-0.38（-1.72 - 0.11）和-0.56（-1.43 - 0.46）；P = 0.249]。仅Hp阳性组的HSENSI显著下降[基线时为1.0（1.0 - 2.0），第12个月时为1.0（0 - 1.0）；P = 0.048]。
根除Hp对肝脂肪变性无长期影响，但在非酒精性脂肪性肝病纤维化评分和HSENSI方面显示出改善趋势。这些结果需要进行更大规模的配对活检研究。
