Abdel-Razik Ahmed, Mousa Nasser, Elhelaly Rania, Elzehery Rasha, Hasan Ahmad S, Abdelsalam Mostafa, Seif Ahmed Salah, Tawfik Ahmed M, El-Wakeel Niveen, Eldars Waleed
Tropical Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Clinical Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Front Med (Lausanne). 2020 Mar 24;7:96. doi: 10.3389/fmed.2020.00096. eCollection 2020.
The relationship between liver cirrhosis and () is a debatable matter. The aim of this study is to evaluate the possible association between infection and liver cirrhosis. A single-center prospective cohort pilot study of 558 patients with cirrhosis was followed up for 1 year. Serum C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), nitric oxide (NO), vascular endothelial growth factor (VEGF) levels and Fecal antigen were evaluated by enzyme-linked immunosorbent assay (ELISA). All patients with positive were treated and then followed up for 3 months. Participants with eradicated were followed up for one further year. -positive patients (48.4%) were associated with increased levels of serum CRP, TNF-α, IL-6, NO, and VEGF, as well as increased incidence of varices, portal hypertensive gastropathy, gastric antral vascular ectasia, hepatocellular carcinoma (HCC), spontaneous bacterial peritonitis, hepatic encephalopathy, portal vein thrombosis (PVT), and hepatorenal syndrome (all < 0.05). Multivariate analysis models revealed that the presence of was an independent risk variable for the development of portal vein thrombosis and hepatocellular carcinoma ( = 0.043, = 0.037) respectively. After treatment of infection, there was a significant reduction in all measured biochemical parameters and reported cirrhotic complications (all < 0.05). Incidence of PVT and HCC development increased with infection through increased inflammatory markers and vascular mediators. Moreover, its eradication may reduce the incidence of these complications.
肝硬化与（）之间的关系是一个有争议的问题。本研究的目的是评估（）感染与肝硬化之间可能存在的关联。对558例肝硬化患者进行了单中心前瞻性队列试点研究，随访1年。采用酶联免疫吸附测定（ELISA）法评估血清C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、一氧化氮（NO）、血管内皮生长因子（VEGF）水平以及粪便（）抗原。所有（）检测呈阳性的患者均接受治疗，然后随访3个月。（）被根除的参与者再随访1年。（）阳性患者（48.4%）血清CRP、TNF-α、IL-6、NO和VEGF水平升高，同时静脉曲张、门静脉高压性胃病、胃窦血管扩张、肝细胞癌（HCC）、自发性细菌性腹膜炎、肝性脑病、门静脉血栓形成（PVT）和肝肾综合征的发生率增加（均P<0.05）。多变量分析模型显示，（）的存在分别是门静脉血栓形成和肝细胞癌发生的独立风险变量（P = 0.043，P = 0.037）。（）感染治疗后，所有检测的生化参数和报告的肝硬化并发症均显著降低（均P<0.05）。PVT和HCC的发生率随着（）感染通过炎症标志物和血管介质的增加而升高。此外，根除（）可能会降低这些并发症的发生率。
