目的 分析代谢相关脂肪性肝病（MAFLD）伴2型糖尿病（T2DM）患者幽门螺杆菌（Hp）感染与炎症因子及肝纤维化进展的关联。 方法 选择2023年4月至2024年3月于河北省中医院肝病科收治的300例MAFLD伴T2DM患者。根据患者感染Hp的情况，将其分为Hp阳性组和Hp阴性组，对比两组的临床资料及炎症因子指标、肝纤维化指标。另外，将Hp阳性组患者随机分为干预组与对照组，干预组将接受常规Hp根除治疗方案，对照组则给予安慰剂治疗。采用Pearson相关分析探究Hp感染与炎症因子、肝纤维化指标之间的相关性。采用二元logistic回归分析影响肝纤维化进展的独立危险因素。采用ROC曲线分析Hp感染与炎症因子指标预测肝纤维化进展的价值。 结果 Hp阳性组和Hp阴性组的年龄、空腹血糖（FPG）、糖化血红蛋白（HbA1c）、总胆红素（TBIL）、直接胆红素（DBIL）、间接胆红素（IBIL）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、C反应蛋白（CRP）、肝脏硬度值（LSM）等资料相比，差异有统计学意义（P < 0.05）。干预组干预后的TNF-α、IL-6、CRP、LSM水平均低于对照组（P < 0.05）。Pearson相关性分析显示，患者的Hp检测值（DPM）水平与TNF-α、IL-6、CRP、LSM水平均呈正相关（P < 0.05）。二元logistic回归分析显示，Hp感染阳性、TNF-α升高、IL-6升高、CRP升高均为影响肝纤维化进展的独立危险因素（P < 0.05）。ROC曲线显示，Hp感染、TNF-α、IL-6、CRP的曲线下面积分别为0.800、0786、0.769、0.783，均低于联合检测的曲线下面积0.896（P < 0.05）。 结论 MAFLD伴T2DM患者的DPM与炎症因子（TNF-α、IL-6、CRP）及肝纤维化进展密切相关，且联合检测时对于预测肝纤维化进展具有重要价值，能够为临床评估肝纤维化进展风险提供可靠依据。

Objective To explore the correlation between helicobacter pylori （Hp） infection and inflammatory factors， as well as its association with the progression of liver fibrosis in patients with metabolically associated fatty liver disease （MAFLD） and type 2 diabetes mellitus （T2DM）. Methods A total of 300 patients diagnosed with MAFLD and T2DM who were admitted to the Hepatology Department of Hebei Hospital of Traditional Chinese Medicine between April 2023 and March 2024 were recruited. Based on Hp infection status， these patients were classified into an Hp-positive group and an Hp-negative group. Subsequently， the clinical data， inflammatory factors， and liver fibrosis indices of the two groups were comprehensively compared. Furthermore， the patients in the Hp-positive group were randomly assigned to an intervention group and a control group. The intervention group received standard Hp eradication therapy， whereas the control group was administered placebo therapy. Pearson correlation analysis was employed to investigate the associations among Hp infection， inflammatory factors， and liver fibrosis indices. Binary logistic regression analysis was utilized to identify the independent risk factors influencing the progression of liver fibrosis. Results In both the Hp-positive and Hp-negative groups， parameters including age， fasting blood glucose （FPG）， glycosylated hemoglobin （HbA1c）， total bilirubin （TBIL）， direct bilirubin （DBIL）， indirect bilirubin （IBIL）， tumor necrosis factor-α （TNF-α）， and interleukin-6 （IL-6）， along with C-reactive protein （CRP） and liver stiffness measurement （LSM）， were meticulously measured. Statistical analysis revealed that the differences in these parameters between the two groups were significant （P < 0.05）. Specifically， within the experimental setup， the levels of TNF-α， IL-6， CRP， and LSM in the intervention group were notably lower than those in the control group （P < 0.05）. Pearson correlation analysis was employed to explore the relationships among variables， and the results indicated a positive correlation between the Hp detection value （DPM） and the levels of TNF-α， IL-6， CRP， and LSM （P < 0.05）. Furthermore， binary logistic regression analysis was conducted to identify independent risk factors. The findings demonstrated that positive Hp infection， elevated TNF-α， elevated IL-6， and elevated CRP were independent risk factors for the progression of liver fibrosis （P < 0.05）. To evaluate the diagnostic performance， the receiver operating characteristic （ROC） curve analysis was carried out. The areas under the curve （AUC） for HP infection， TNF-α， IL-6， and CRP were 0.800， 0.786， 0.769， and 0.783， respectively. These values were significantly lower than the AUC of 0.896 obtained from the combined detection （P < 0.05）. Conclusions In MAFLD patients with T2DM， DPM is closely associated with inflammatory factors （such as TNF-α， IL-6， and CRP） and the advancement of liver fibrosis. The combined detection of these factors holds significant value in predicting the progression of liver fibrosis. It can offer a reliable foundation for the clinical assessment of the risk of liver fibrosis progression.