门冬氨酸鸟氨酸联合利福昔明治疗肝性脑病的临床疗效  

Clinical effects of ornithine aspartate combined with rifaximin in treatment of acute hepatic encephalopathy

作　　者：杨娟[1] 周世昌[1] 张建立[1] 杨玉秀[2] 

机构地区：[1]郑州市第二人民医院消化内科一病区,河南省郑州市450000 [2]河南省人民医院消化内科,河南省郑州市450000

出　　处：《世界华人消化杂志》2016年第3期415-419,共5页World Chinese Journal of Digestology

摘　　要：目的:研究门冬氨酸鸟氨酸联合利福昔明治疗肝硬化相关性显性肝性脑病的临床疗效.方法:选取河南省人民医院及郑州市第二人民医院2014-02/2015-02诊治的80例合并肝硬化的肝性脑病患者,随机分为门冬氨酸鸟氨酸组(对照A组)、利福昔明治疗组(对照B组)和门冬氨酸鸟氨酸联合利福昔明治疗组(治疗组),治疗7 d后,分别检测各组治疗前后血氨浓度、谷丙转氨酶(alanine aminotransferase,ALT)、血清总胆红素(total bilirubin,TBIL)水平进行评价和比较.结果:7 d治疗后,对照组A、对照组B患者血氨浓度、ALT浓度及TBIL浓度与治疗组对比差异均有统计学意义(血氨:68.14μmol/L±11.13μmol/L,85.22μmol/L±11.19μmol/L vs 45.16μmol/L±11.18μmol/L,t=3.014,P<0.05;t=2.011,P<0.01;ALT:89.21 U/L±11.14 U/L,78.16 U/L±13.02 U/L vs 56.26 U/L±14.04 U/L,t=2.106,P<0.05;t=2.057,P<0.05;TBIL:40.06μmol/L±8.05μmol/L,43.22μmol/L±8.122μmol/L vs 34.09μmol/L±6.18μmol/L,t=1.085,P<0.05;t=1.024,P<0.01).且治疗组总有效率及显效率(85.00%,55.00%)明显高于对照组(52.50%,35.00%)(P<0.05).结论:门冬氨酸鸟氨酸联合利福昔明可以显著改善临床症状并提高临床疗效.AIM： To evaluate the clinical effects of ornithine aspartate combined with rifaximin in the treatment of hepatic encephalopathy with liver cirrhosis.METHODS： Eighty cirrhotic patients with hepatic encephalopathy treated at the Second Hospital of Zhengzhou and He＇nan Provincial People＇s Hospital from February 2014 to February 2015 were randomly divided into an ornithine aspartate treatment group（group A）, a rifaximin treatment group（group B） and an ornithine aspartate plus rifaximin treatment group（group C）. One week later, efficacy and the changes of blood ammonia concentration and hepatic functions were compared.RESULTS： After seven days of treatment, the concentrations of blood ammonia, ALT and TBIL in groups A and B were significantly higher compared with those in group C（blood ammonia： 68.14 μmol/L ± 11.13 μmol/L, 85.22 μmol/L ± 11.19 μmol/L vs 45.16 μmol/L ± 11.18 μmol/L, t = 3.014, 2.011, P〈0.05, 0.01; ALT： 89.21 U/L ± 11.14 U/L, 78.16 U/L ± 13.02 U/L vs 56.26 U/L ± 14.04 U/L, t = 2.106, 2.057, P〈0.05 for both; TBIL： 40.06 μmol/L ± 8.05 μmol/L, 43.22 μmol/L ± 8.122 μmol/L vs 34.09 μmol/L ± 6.18 μmol/L, t = 1.085, 1.024, P〈0.05 and 0.01）. The total effective rate and the improvement rate for the treatment group（85.00% and 55.00%, respectively） were significantly higher than those of groups A and B（P〈0.05 for all）.CONCLUSION： Ornithine aspartate combined with rifaximin in treatment of acute hepaticencephalopathy can effectively ameliorate clinical symptoms and improve the curative effect.

关 键 词：门冬氨酸鸟氨酸 利福昔明 肝硬化相关性肝性脑病 

分 类 号：R575.3[医药卫生—消化系统]