乳果糖对乙肝后肝硬化患者肝功能、炎症及肠道通透性水平的影响  

Influence of lactulose on liver function,inflammatory factor and intestinal permeability levels of hepatitis B cirrhosis

作　　者：季晓军 王伟军 

机构地区：[1]浙江省青田县中医院消化科,浙江323900 [2]浙江省台州市恩泽医疗中心(集团)路桥医院检验科,浙江318050

出　　处：《实用药物与临床》2014年第9期1158-1161,共4页Practical Pharmacy and Clinical Remedies

基　　金：浙江省台州市科技局课题立项(061KY32)

摘　　要：目的 探讨乳果糖对乙肝后肝硬化患者肝功能、炎症因子及肠道通透性水平的影响.方法 将80例乙肝后肝硬化患者随机分为治疗组和对照组.两组患者均行利尿、常规保肝和对症支持治疗,治疗组在此基础上加用乳果糖口服液10 g,2～3次/d,并根据大便情况适当调整乳果糖剂量.1个月后观察两组患者治疗前后肝功能、炎症因子、肠道通透性水平和自发性腹膜炎的发生率.结果 治疗1个月后,两组患者ALT、AST和TB水平均较治疗前显著下降（P＜0.05）,治疗组下降程度显著高于对照组（P＜0.05）;两组血清IL-6、IL-8和TNF-α均较治疗前显著下降（P＜0.05）,治疗组下降程度显著高对照组（P＜0.05）;两组患者内毒素、D-乳酸和PCT水平均较治疗前明显下降（P＜0.05或P＜0.01）,治疗组下降幅度较对照组更明显（P＜0.05）.治疗过程中有13例发生SBP,其中治疗组3例（7.5％）,对照组10例（25.0％）,治疗组SBP的发生率明显低于对照组（x2=4.50,P＜0.05）.结论 乳果糖能促进乙肝后肝硬化患者肝功能恢复,降低肠道通透性和炎症因子的水平,保护肠粘膜屏障功能,从而减少自发性腹膜炎的发生率.Objective To discuss the influence of lactulose on liver function,inflammatory factor and intestinal permeability levels of hepatitis B cirrhosis.Methods 80 cases of patients with hepatitis B cirrhosis were divided into treatment group and control group at random.The patients in the two groups were given symptomatic and supportive treatment of diuresis and routine liver protection,and the patients in treatment group were given 10 g lactulose oral liquid 2 or 3 times daily,which was adjusted properly in accordance with condition of bowls.After 1 month＇s medical treatment,liver function,inflammatory factor,intestinal permeability levels and the occurrence rates of spontaneous peritonitis were observed before and after medical treatment.Results After 1 month＇s medical treatment,ALT,AST and TB levels of patients in two groups declined obviously（P ＜ 0.05）,and the declining rate in treatment group was much higher than that in control group （P ＜ 0.05）.The serum IL-6 and IL-8 and TNF-α of patients in the two groups declined obviously than before（P ＜ 0.05）,and the declining rate in treatment group was much higher than that in control group（P ＜ 0.05）.The serum plasma endotoxin,D-lactic acid and PCT of patients in two groups declined obviously than before （P ＜ 0.05）,and the declining rate in treatment group was much higher than that in control group （P ＜0.05）.13 cases of SBP appeared in the therapeutic process,which included 3 cases（7.5％）in treatment group and 10 cases （25.0％）in control group,and the occurrence rate of SBP in treatment group was lower than that in con trol group （x2 =4.50,P ＜ 0.05）.Conclusion Lactulose has reliable effect on the recovery of liver function of hepatitis B cirrhosis,reduces inflammatory factor,intestinal permeability levels and occurrence rate of spontaneous peritonitis.

关 键 词：肝硬化 乳果糖 肝功能 炎性因子 

分 类 号：R575.2[医药卫生—消化系统]