乳果糖和益生菌制剂预防肝性脑病的临床疗效观察(1)
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[摘要] 目的：探讨乳果糖和益生菌制剂预防肝硬化上消化道出血后肝性脑病(HE)的疗效。方法：将68例确诊肝硬化合并上消化道出血患者随机分为对照组及治疗组 (各34例)，对照组采用常规综合治疗，治疗组在常规综合治疗的基础上加用乳果糖和益生菌制剂口服，2周后观察疗效。结果：治疗组及对照组发生HE患病率分别为17.7%及55.9%，差异有统计学意义(P<0.05)。与对照组比较，治疗组血氨含量明显下降，数字连接实验(NCT)明显缩短，数字符号试验(DST)评分增加(P<0.01)。两组治疗后肝功能均明显改善，但治疗组和对照组比较差异无统计学意义(P>0.05)。结论：在基础治疗的前提下，乳果糖和益生菌制剂能有效预防肝硬化上消化道出血后HE的发生。
[关键词] 肝性脑病；乳果糖；益生菌制剂
[中图分类号] R747.9[文献标识码]A [文章编号]1673-7210(2011)08(a)-075-02
Observation on the efficacy of Lactulose and Probiotics in preventing hepatic encephalopathy
YANG Lili, ZOU Bing, WANG Junping, DU Yiping, HE Min, GUAN Xingqiu
Digestive Department of the Shenzhen Hospital of Peking University, Guangdong Province, Shenzhen 518036, China
[Abstract] Objective: To explore the efficacy of Lactulose and Probiotics in preventing hepatic encephalopathy (HE) after upper gastrointestinal bleeding. Methods: 68 cases of cirrhosis complicated with upper gastrointestinal bleeding were randomly divided into therapy group (34 cases) and control group (34 cases). Patients in the control group received routine comprehensive therapy while those in the therapy group received combined Lactulose and Probiotics. The efficacy after 2 weeks was observed. Results: The incidence of hepatic encepha1opathy was 17.7% in the therapy group and 55.9% in the control group，there was significant difference between two groups (P<0.05). The blood ammonia in the therapy group decreased obviously; number connection test (NCT) was shorter and number digit symbol test (DST) increased compared with the control group (P<0.01). Hepatic function all improved significantly in two groups after treatment, but there was no statistical significance (P>0.05). Conclusion: Lactulose and Probiotics can prevent hepatic encephalopathy effectively after upper gastrointestinal bleeding caused by cirrhosis.
[Key words] Hepatic encepha1opathy; Lactulose; Probiotics
肝性脑病(hepatic encephalopathy，HE)是由严重肝病引起的，以代谢紊乱为基础的中枢神经系统功能失调综合征，其主要临床表现为意识障碍、行为异常及昏迷[1]。其发生严重影响肝病患者的生活质量，也是该类患者最常见的死亡原因之一。目前对肝性脑病发病机制的研究仍停留在某几种假说的水平。但血氨增高仍是肝硬化患者并发肝性脑病发病机制的关键因素[2] ......
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