益生菌制剂对肝硬化上消化道出血后血氨的影响(1)
[摘要] 目的 探讨益生菌制剂对肝硬化上消化道出血后血氨的影响。 方法 将笔者所在医院112例肝硬化患者随机分为治疗组和对照组，每组56例，前者采用常规治疗加口服益生菌制剂，后者只采用常规治疗。比较两组患者治疗后的血氨水平和精神意识变化情况。 结果 治疗组患者血氨水平下降明显，差异有统计学意义(P<0.05)，对照组患者血氨水平下降差异无统计学意义(P>0.05)。治疗组患者精神意识变化情况方面明显优于对照组，差异有统计学意义(P<0.05)。结论 采用益生菌制剂治疗肝硬化高血氨症，能有效将血氨水平降低，并且能改善患者的睡眠质量、精神状况、性格行为等，值得在临床上进一步推广使用。
[关键词] 益生茵制剂；肝硬化；上消化道出血；血氨
[中图分类号] R575.2?[文献标识码] B?[文章编号] 2095-0616(2012)14-56-02
Effect of probiotics on blood ammonia levels after upper gastrointestinal bleeding in cirrhosis of the liver
WAN?Yu
Digestion Internal Medicine,Panyu Central Hospital of Guangzhou City,Guangzhou 511400,China
[Abstract] Objective To investigate the effect of probiotics to influence ammonia after upper gastrointestinal bleeding in cirrhosis of the liver. Methods 112 patients of our hospital with cirrhosis of the liver were randomly divided into the treatment group and control group,Each group with 56 cases.The former group was cared by conventional treatment plus oral probiotics. The later group was cared by the conventional therapy.The blood ammonia levels and change of consciousness of two goup were compared after Treatment. Results The blood ammonia levels of the treatment group decreased significantly,the differences were statistically significant(P<0.05). The differences of the blood ammonia levels of the control group weren’t statistically significant(P>0.05). The treatment group was better than the control group in the change of consciousness,the differences were statistically significant(P<0.05). Conclusion Probiotics in the treatment of cirrhosis with hyperammonemia can effectively reduce the blood ammonia level and improve quality of sleep,mental state,personality,behavior of the patients,it is worthy of further extension in clinical use.
[Key words] Probiotics;Cirrhosis of liver;Upper gastrointestinal bleeding;Ammonia
目前，在肝性脑病发病机制的研究中仍有几种假说，其中肝硬化患者发生肝性脑病的关键因素是血氨的升高[1]。通常在消化道出血后，会由部分细菌将其分解并产生大量血氨，进而出现肝性脑病，所以有效控制血氨显得非常重要。本研究针对益生菌制剂对肝硬化上消化道出血后血氨的影响进行研究，选用笔者所在医院2007年3月～2012年1月收治的112例肝硬化患者，现报道如下。
1?资料与方法
1.1?一般资料
所选112例患者均通过病史询问、症状体征、辅助检查(超声、病理活检等)确诊为肝硬化。入选标准：(1)近2周有消化道的出血；(2)无明显肝性脑病诱因，如使用镇静剂等；(3)无神经精神病变者；(4)无严重心肺功能损伤、恶性肿瘤、严重水电解质紊乱等[2]。现将所有患者随机分为治疗组和对照组，治疗组56例，其中男34例，女22例，年龄28～72岁，平均(42.2±2.3)岁；对照组56例，男35例，女21例，年龄29～74岁，平均(41.4±2.7)岁。两组患者性别、年龄等一般资料比较，差异均无统计学意义(P>0.05)，具有可比性。
1.2?方法
对照组使用常规治疗，包括保肝降酶、抗纤维化、止血抑酸、利尿、抗感染、限制蛋白质总的摄入量、 补充支链氨基酸、防止水电解质紊乱，以及对症治疗等[3]，2周后观察疗效。
治疗组采用常规治疗加益生菌制剂常乐康(山东科兴生物制品有限公司，S20020014)口服治疗，2包/次，3次/d，常规治疗方法同对照组，服用2周后观察疗效。, 百拇医药(万瑜)
[关键词] 益生茵制剂；肝硬化；上消化道出血；血氨
[中图分类号] R575.2?[文献标识码] B?[文章编号] 2095-0616(2012)14-56-02
Effect of probiotics on blood ammonia levels after upper gastrointestinal bleeding in cirrhosis of the liver
WAN?Yu
Digestion Internal Medicine,Panyu Central Hospital of Guangzhou City,Guangzhou 511400,China
[Abstract] Objective To investigate the effect of probiotics to influence ammonia after upper gastrointestinal bleeding in cirrhosis of the liver. Methods 112 patients of our hospital with cirrhosis of the liver were randomly divided into the treatment group and control group,Each group with 56 cases.The former group was cared by conventional treatment plus oral probiotics. The later group was cared by the conventional therapy.The blood ammonia levels and change of consciousness of two goup were compared after Treatment. Results The blood ammonia levels of the treatment group decreased significantly,the differences were statistically significant(P<0.05). The differences of the blood ammonia levels of the control group weren’t statistically significant(P>0.05). The treatment group was better than the control group in the change of consciousness,the differences were statistically significant(P<0.05). Conclusion Probiotics in the treatment of cirrhosis with hyperammonemia can effectively reduce the blood ammonia level and improve quality of sleep,mental state,personality,behavior of the patients,it is worthy of further extension in clinical use.
[Key words] Probiotics;Cirrhosis of liver;Upper gastrointestinal bleeding;Ammonia
目前，在肝性脑病发病机制的研究中仍有几种假说，其中肝硬化患者发生肝性脑病的关键因素是血氨的升高[1]。通常在消化道出血后，会由部分细菌将其分解并产生大量血氨，进而出现肝性脑病，所以有效控制血氨显得非常重要。本研究针对益生菌制剂对肝硬化上消化道出血后血氨的影响进行研究，选用笔者所在医院2007年3月～2012年1月收治的112例肝硬化患者，现报道如下。
1?资料与方法
1.1?一般资料
所选112例患者均通过病史询问、症状体征、辅助检查(超声、病理活检等)确诊为肝硬化。入选标准：(1)近2周有消化道的出血；(2)无明显肝性脑病诱因，如使用镇静剂等；(3)无神经精神病变者；(4)无严重心肺功能损伤、恶性肿瘤、严重水电解质紊乱等[2]。现将所有患者随机分为治疗组和对照组，治疗组56例，其中男34例，女22例，年龄28～72岁，平均(42.2±2.3)岁；对照组56例，男35例，女21例，年龄29～74岁，平均(41.4±2.7)岁。两组患者性别、年龄等一般资料比较，差异均无统计学意义(P>0.05)，具有可比性。
1.2?方法
对照组使用常规治疗，包括保肝降酶、抗纤维化、止血抑酸、利尿、抗感染、限制蛋白质总的摄入量、 补充支链氨基酸、防止水电解质紊乱，以及对症治疗等[3]，2周后观察疗效。
治疗组采用常规治疗加益生菌制剂常乐康(山东科兴生物制品有限公司，S20020014)口服治疗，2包/次，3次/d，常规治疗方法同对照组，服用2周后观察疗效。, 百拇医药(万瑜)