门冬氨酸鸟氨酸对隐匿性肝性脑病患者睡眠结构的影响  

Effects of L-ornithine-L-aspartate on sleep structure in patients with covert hepatic encephalopathy

作　　者：杨欢[1] 金晓燕[2] 董慧幸 张欢欢[3] 王霆[4] YANG Huan;JIN Xiao-yan;DONG Hui-xing;ZHANG Huan-huan;WANG Ting(Endocrinology Department;Respiratory Department;Clinical Laboratory;Department of Gastroenterology,Tongren Hospital,Shanghai Jiaotong University School of Medicine,SHANGHAI 200336,China)

机构地区：[1]上海交通大学医学院附属同仁医院内分泌科,上海200336 [2]上海交通大学医学院附属同仁医院呼吸内科,上海200336 [3]上海交通大学医学院附属同仁医院检验科,上海200336 [4]上海交通大学医学院附属同仁医院消化内科,上海200336

出　　处：《中国新药与临床杂志》2018年第8期488-491,共4页Chinese Journal of New Drugs and Clinical Remedies

基　　金：上海市长宁区科学技术委员会科研基金(CNKW2014Z02)

摘　　要：目的了解隐匿性肝性脑病(CHE)患者睡眠结构的变化以及门冬氨酸鸟氨酸(LOLA)治疗对CHE患者睡眠结构的影响。方法肝硬化伴CHE患者59例随机分为常规治疗组(29例)和LOLA组(30例),以25例不伴有肝性脑病的肝硬化患者为对照组(肝硬化组)。所有CHE患者均进行常规治疗,LOLA组在常规治疗的基础上给予LOLA注射液(10 g·d^(-1),静脉滴注)治疗,共3 d。治疗前后对所有患者进行睡眠结构监测,同时检测血浆氨和血清钠、丙氨酸转氨酶水平。结果 CHE患者的总睡眠时间、微觉醒次数以及N1期、N2期睡眠时间占比均高于肝硬化组,而N3期、R期睡眠时间占比低于肝硬化组,有显著差异(P<0.05)。治疗后,LOLA组患者的总睡眠时间,微觉醒次数以及N1期、N2期睡眠时间占比均低于常规治疗组,而N3期、R期睡眠时间占比高于常规治疗组,有显著差异(P<0.05);同时,LOLA组血氨水平较对照组低(P<0.05)。结论 CHE患者存在睡眠结构的紊乱,LOLA对此有一定的治疗价值。ATM To investigate the change of sleep structure in patients with covert hepatic encephalopathy（CHE） and the treatment effect of L-ornithine-L-aspartate（LOLA） on sleep structure of CHE patients. METHODS Totally 59 hepatic cirrhosis patients complicated with CHE were divided into 2 groups：conventional treatment group（29 patients） and LOLA treatment group（30 patients） according to the random number table method, and 25 hepatic cirrhosis patients with no CHE were used as control group（ cirrhosis group）. All CHE patients were given routine treatment, and the patients in the LOLA treatment group had been given LOLA injection（ 10 g·d^-1, ivgtt） on the basis of routine treatment for 3 days. Before and after the treatment, sleep patterns were monitored and the levels of plasma ammonia, serum sodium and alanine transaminase were measured. RESULTS Total sleep time, microarousal times, and N1 phase ratio and N2 phase ratio in CHE patients were higher than those of the cirrhosis group（P〈0.05）, and N3 phase ratio and R phase ratio were lower（ P〈0.05）. After the treatment, total sleep time, microarousal times, and N1 phase ratio and N2 phase ratio in the LOLA treatment group were lower than those of the conventional treatment group（P〈0.05）, and N3 and R phase ratio were higher（P〈0.05）. Blood ammonia level of the LOLA treatment group was lower than that in the conventional treatment group（P〈0.05）. CONCLUSION CHE patients have a disturbance of sleep structure, and LOLA can improve the sleep structure disorder in patients with CHE.

关 键 词：肝性脑病 门冬氨酸鸟氨酸 睡眠 丙氨酸转氨酶 

分 类 号：R575.3[医药卫生—消化系统]