门冬氨酸鸟氨酸联合乳果糖治疗肝性脑病的临床疗效观察(1)
摘要：目的 观察门冬氨酸鸟氨酸联合乳果糖治疗肝性脑病(HE)的疗效。方法 85例肝硬化并发肝性脑病患者被随机分为两组，对照组(n=39)在常规治疗基础上单用乳果糖口服，观察组(n=46)在常规治疗基础上加用门冬氨酸鸟氨酸和乳果糖联合治疗，治疗1 w后观察疗效，监测治疗前后临床症状、血氨及肝功能。结果 在治疗结束时，对照组显效13例，有效14 例，无效12例，观察组显效21例，有效18例，无效7例，对照组总有效率69.2%，观察组总有效率84.7%，观察组总有效率高于对照组，差异有统计学意义(P<0.05)。观察组丙氨酸氨基转移酶、天冬氨酸氨基转移酶和总胆红素、血氨较对照组明显下降，差异有统计学意义(P<0.05)。结论 门冬氨酸鸟氨酸联合乳果糖治疗HE疗效显著，可明显降低血氨水平，缓解HE严重程度。
关键词：肝性脑病；门冬氨酸鸟氨酸；乳果糖
Clinical Effect Observation of Ornithine Aspartate Combined with Lactulose in Treatment of Hepatic Encephalopathy
, 百拇医药
YI Li-ping
(Department of Gastroenterology， Shijingshan Teaching Hospital of Capital Medical University， Beijing Shijingshan Hospital， Beijing 100043，China)
Abstract：Objective To observe the effect of ornithine aspartate combined with lactulose in the treatment of hepatic encephalopathy. Methods 85 patients with hepatic encephalopathy randomized divided into 2 groups. Patients in the control group(n=39) were treated with lactulose alone added to the usual treatment， patients in the observation group(n=46) received ornithine aspartate combined with lactulose added to the usual treatment， to observe the effect after 1 week of the treatment， to monitor the clinical symptoms， blood ammonia and liver function before and after treatment. Results At the end of treatment， the control group showed significant effective 13 cases， effective 14 cases， ineffective 12 cases， and the total effective rate was 69.2%； the observation group showed significant effective 21 cases， effective 18 cases， ineffective 7 cases， and the total effective rate was 84.7%， the efficiency of observation group was higher than that of the control group， the difference was statistically significant (P<0.05). Alanine aminotransferase (ALT)， aspartate aminotransferase (AST)， total bilirubin and blood ammonia of the observation group were significantly decreased compared with those of the control group， the differences were statistically significant (P<0.05).Conclusion L-ornithine-L-aspartate combined with lactulose in the treatment of HE has obvious curative effect， can significantly reduce the level of blood ammonia， alleviate the severity of HE.
, 百拇医药
Key words：Hepatic encephalopathy； Ornithine aspartate； Lactulose
肝性脑病是由肝功能严重失调或障碍所致、以代谢紊乱为主要特征的中枢神经系统功能失调综合征。氨代谢紊乱引起的氨中毒是肝性脑病、特别是门体分流性脑病的重要发病机制[1]。乳果糖可酸化肠道，并促进乳酸杆菌等有益菌的大量繁殖、抑制产氨细菌的生长，从而减少氨的形成与吸收，其轻泻作用有助于肠内含氨毒性物质的排出。门冬氨酸鸟氨酸可提供尿素和谷氨酰氨合成的底物，促进尿素合成、降低血氨。本研究应用乳果糖联合门冬氨酸鸟氨酸治疗肝硬化并肝性患者，观察其疗效。现报告如下。
1资料与方法
1.1一般资料 选取2013年1月～2015年12月于我院消化内科住院的肝性脑病患者85例，根据临床症状、体征及实验室检查诊断并符合相关诊断标准[2]，将入选患者随机分为对照组、观察组两组。两组患者一般资料见表1，两组患者在性别、年龄、病程、原发病病因、HE分期等方面比较无显著性差异(P>0.05)。, 百拇医药(伊丽萍)
关键词：肝性脑病；门冬氨酸鸟氨酸；乳果糖
Clinical Effect Observation of Ornithine Aspartate Combined with Lactulose in Treatment of Hepatic Encephalopathy
, 百拇医药
YI Li-ping
(Department of Gastroenterology， Shijingshan Teaching Hospital of Capital Medical University， Beijing Shijingshan Hospital， Beijing 100043，China)
Abstract：Objective To observe the effect of ornithine aspartate combined with lactulose in the treatment of hepatic encephalopathy. Methods 85 patients with hepatic encephalopathy randomized divided into 2 groups. Patients in the control group(n=39) were treated with lactulose alone added to the usual treatment， patients in the observation group(n=46) received ornithine aspartate combined with lactulose added to the usual treatment， to observe the effect after 1 week of the treatment， to monitor the clinical symptoms， blood ammonia and liver function before and after treatment. Results At the end of treatment， the control group showed significant effective 13 cases， effective 14 cases， ineffective 12 cases， and the total effective rate was 69.2%； the observation group showed significant effective 21 cases， effective 18 cases， ineffective 7 cases， and the total effective rate was 84.7%， the efficiency of observation group was higher than that of the control group， the difference was statistically significant (P<0.05). Alanine aminotransferase (ALT)， aspartate aminotransferase (AST)， total bilirubin and blood ammonia of the observation group were significantly decreased compared with those of the control group， the differences were statistically significant (P<0.05).Conclusion L-ornithine-L-aspartate combined with lactulose in the treatment of HE has obvious curative effect， can significantly reduce the level of blood ammonia， alleviate the severity of HE.
, 百拇医药
Key words：Hepatic encephalopathy； Ornithine aspartate； Lactulose
肝性脑病是由肝功能严重失调或障碍所致、以代谢紊乱为主要特征的中枢神经系统功能失调综合征。氨代谢紊乱引起的氨中毒是肝性脑病、特别是门体分流性脑病的重要发病机制[1]。乳果糖可酸化肠道，并促进乳酸杆菌等有益菌的大量繁殖、抑制产氨细菌的生长，从而减少氨的形成与吸收，其轻泻作用有助于肠内含氨毒性物质的排出。门冬氨酸鸟氨酸可提供尿素和谷氨酰氨合成的底物，促进尿素合成、降低血氨。本研究应用乳果糖联合门冬氨酸鸟氨酸治疗肝硬化并肝性患者，观察其疗效。现报告如下。
1资料与方法
1.1一般资料 选取2013年1月～2015年12月于我院消化内科住院的肝性脑病患者85例，根据临床症状、体征及实验室检查诊断并符合相关诊断标准[2]，将入选患者随机分为对照组、观察组两组。两组患者一般资料见表1，两组患者在性别、年龄、病程、原发病病因、HE分期等方面比较无显著性差异(P>0.05)。, 百拇医药(伊丽萍)