益生菌在乙型肝炎肝硬化患者轻微肝性脑病中的应用效果  

Effect of Probiotics in Improvement of Minimal Hepatic Encephalopathy in Cirrhosis Patients with Hepatitis B Virus

作　　者：王伟芳 曹建彪[2] 熊锦华[2] 郭汉斌[2] 马丽[2] 陈力强[2] 

机构地区：[1]解放军医学院研究生院,北京100853 [2]北京军区总医院全军肝病治疗中心,北京100700

出　　处：《解放军医药杂志》2015年第2期17-20,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：中国肝炎防治基金会王宝恩肝纤维化研究基金(XJS201302)

摘　　要：目的探讨益生菌在改善乙型肝炎肝硬化轻微型肝性脑病(MHE)应用效果。方法选择2013年9月—2014年10月北京军区总医院全军肝病治疗中心确诊的乙型肝炎肝硬化MHE 60例,按治疗方法分为益生菌组和对照组各30例,两组均给予常规治疗,益生菌组在此基础上给予地衣芽孢杆菌治疗。观察两组不良反应,治疗前后血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)及血氨(NH3)水平,Child-pugh评分,数字连接试验-A(NCT-A)及临界闪烁频率(CFF)值。结果 60例中有57例完成试验,两组均出现1例显性肝性脑病,对照组出现上消化道出血1例。益生菌组治疗后ALT、AST及Child-pugh评分较治疗前下降,ALT较对照组降低(P<0.05);对照组治疗后ALT、AST较治疗前下降(P<0.05)。两组治疗后NH3、NCT-A较治疗前下降(P<0.05);益生菌组治疗后NH3低于对照组,CFF值较治疗前和对照组升高(P<0.05)。治疗后益生菌组NCT-A及CFF阳性发生率低于对照组(P<0.05)。结论益生菌可以改善乙型肝炎肝硬化MHE患者的肝功能。Objective To investigate the effect of probiotics in improvement of minimal hepatic encephalopathy（ MHE） in cirrhosis patients with hepatitis B virus. Methods A total of 60 cirrhosis patients with hepatitis B virus diagnosed during September 2013 and October 2014 were divided into probiotics group（ n = 30） and control group（ n = 30）according to therapeutic methods. All the patients received conventional treatment,and probiotics group received additional bacillus licheniformis treatment. The adverse reaction,and serum alanine transarninase（ ALT）,aspartate aminotransferase（ AST）,NH3 level,Child-pugh score,and values of number connection test-A（ NCT-A） and critical flicker frequency（ CFF） before and after the therapies in the two groups were observed. Results Among the 60 patients,57 patients completed the trial. One patient was found with overt hepatic encephalopathy（ OHE） in each group,and one patient had upper gastrointestinal hemorrhage in control group. After the treatment,the ALT,AST and Child-pugh scores in probiotics group were significantly decreased compared with those before the treatment and ALT value in probiotics group was also significantly decreased than that in control group（ P〈0. 05）. The ALT and AST values after the treatment in control group were significantly decreased（ P〈0. 05）. The NH3 and NCT-A levels after the treatment were significantly decreased compared with those before the treatment in the two groups（ P〈0. 05）; after the treatment,NH3 level in probiotics group was significantly decreased compared with that in control group,and CFF value was significantly increased in probiotics group compared with those before the treatment and in the control group（ P〈0. 05）. The positive incidence rates of NCT-A and CFF in probiotics group were significantly lower than those in control group（ P〈0. 05）. Conclusion Probiotics may improve the liver function of MHE in cirrhosis patients with hepatitis B virus.

关 键 词：乙型肝炎 肝硬化 肝性脑病 益生元 数字连接试验 临界闪烁频率 

分 类 号：R575.2[医药卫生—消化系统]