الفهرس 
Hepatic encephalopathyOnly 14 pages are availabe for public view
 |  | from | 101 |  |  |
| | | from | 101 | | |
Abstract
Hepatic encephalopathy is a common and serious complication affecting patients with liver disease. There are various mechanisms for aetiopathogenesis of hepatic encephalopathy. Ammonia is the substance most often incriminated in the pathogenesis of encephalopathy. Most of the ammonia is of gut origin where it is produced by bacterial flora. Stomach when infected with H.pylori is an alternative site of ammonia production. The present study aimed to study the prevalence of H. pylori infection among patients with liver cirrhosis including those with hepatic encephalopathy and to determine if any correlation between the presence of H. pylori and the grading of hepatic encephalopathy. The study was conducted on one hundred patients (50 patients with liver cirrhosis with hepatic encephalopathy and 50 patients with liver cirrhosis without hepatic encephalopathy) who were selected from the patients admitted in Helwan fevers hospital. All patients stool has been examined for the determination of H. pylori antigens based on ELISA technique (enzyme linked immunosorbent assay). All patients has been subjected to estimation of arterial blood ammonia level. Prevalence of H. pylori infection in the studied groups (patients with liver cirrhosis with hepatic encephalopathy and patients with liver cirrhosis without hepatic encephalopathy) was 80% for liver cirrhosis with hepatic encephalopathy, and 60% for liver cirrhosis without hepatic encephalopathy.
Prevalence of H. pylori.was found significantly increasing with the severity of hepatic encephalopathy. There is a rising H. pylori Prevalence in hepatic encephalopathy group according to the grade of hepatic encephalopathy, it was 9 (64%)in grade I hepatic encephalopathy patients , 11 (78%)in grade II hepatic encephalopathy patients, 11 (91%)in grade III hepatic encephalopathy and 9 (90%) in grade IV hepatic encephalopathy patients. There is a significantly rising blood ammonia level in hepatic encephalopathy group with increasing the grade of hepatic encephalopathy, it was 80.40±5.63 mmol/l in grade I hepatic encephalopathy patients, 84.35±3.2 mmol/l ingrade II hepatic encephalopathy patients, 87±3.9 mmol/l in grade III hepatic encephalopathy and 91±2.8 mmol/l in grade IV hepatic encephalopathy patients. Conclusion: There is a significant difference between H. pylori prevalence in patients with liver cirrhosis with and without hepatic encephalopathy. Also there is increasing prevalence of H.pylori and arterial blood ammonia level with increasing the grade and severity of hepatic encephalopathy.