微生态制剂联合门冬氨酸鸟氨酸对肝硬化并发肝性脑病患者的治疗效果  

Therapeutic effect of probiotics combined with ornithine aspartate on patients with liver cirrhosis complicated with hepatic encephalopathy

作　　者：梅冬雪 张国顺 王素颖 Mei Dongxue;Zhang Guoshun;Wang Suying(Department of Gastroenterology,Affiliated Hospital of North China University of Science and Technology,Tangshan 063000)

机构地区：[1]华北理工大学附属医院消化内科,唐山063000

出　　处：《中国综合临床》2023年第5期326-331,共6页Clinical Medicine of China

基　　金：河北省医学科学研究课题计划项目(20210375)。

摘　　要：目的探讨微生态制剂联合门冬氨酸鸟氨酸对肝硬化并发肝性脑病患者的安全性及治疗效果。方法选取2017年1月至2021年12月华北理工大学附属医院住院的肝性脑病患者72例,按照组间性别、年龄可比的原则,采用随机数字表法分为观察组(36例)和对照组(36例)。对照组给予门冬氨酸鸟氨酸治疗,观察组给予微生态制剂联合门冬氨酸鸟氨酸治疗。观察两组患者疗效及其对血清炎症因子、肠道菌群和肠黏膜屏障功能的影响。结果观察组患者治疗的总有效率高于对照组[97.22%(35/36)比83.33%(30/36)],组间差异无统计学意义(χ^(2)=2.53,P=0.112)。治疗后与治疗前差值治疗组患者较对照组患者丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天冬氨酸氨基转移酶(aspartate aminotransferase,AST)、总胆红素(total bilirubin,TBIL)、血氨、白细胞介素(interleukin,IL)6、IL-8、肿瘤坏死因子α(tumor necrosis factor,TNF-α)、C反应蛋白(C reactive protein,CRP)、肠杆菌、肠球菌含量、内毒素、D-乳酸、二胺氧化酶、数字连接实验(digital connection experiment,NCT)时间均明显降低[(-130.89±31.67)U/L比(-98.64±43.41)U/L,(-137.81±31.92)U/L比(-79.58±45.42)U/L,(-57.13±21.07)μmol/L比(-45.92±18.11)μmol/L,(-164.06±19.30)μmol/L比(-148.98±12.97)μmol/L,(-5.35±2.30)ng/L比(-2.18±2.77)ng/L,(-5.51±2.07)μmol/L比(-3.72±1.50)ng/L,(-12.60±3.65)ng/L比(-7.97±5.86)ng/L,(-45.95±20.34)mg/L比(-21.14±19.09)mg/L,(-2.70±1.53)比(-1.31±2.47),(-2.50±1.26)比(-1.39±1.97),(-0.32±0.09)EU/ml比(-0.19±0.09)EU/ml,(-47.58±18.52)nmol/L比(-32.31±22.21)nmol/L,(-3.44±1.06)U/ml比(-1.86±1.30)U/ml,(-31.75±10.09)s比(-14.58±10.10)s];而双歧杆菌、乳杆菌、数字符号试验(digit symbol test,DST)评分明显升高[(2.77±1.76)分比(1.13±2.06)分,(3.23±1.61)分比(1.06±2.31)分,(32.58±5.72)分比(16.33±6.16)分],差异均有统计学意义(t值分别为3.60、6.29、2.42、3.89、5.28、4.21、4.03、5.34、2.8Objective To explore the safety and therapeutic effect of probiotics combined with ornithine aspartate on patients with liver cirrhosis complicated by hepatic encephalopathy.Methods 72 patients with hepatic encephalopathy hospitalized in the Affiliated Hospital of North China University of Technology from January 2017 to December 2021 were randomly.According to the principle of comparability between groups in terms of gender and age,the group was divided into an observation group(36 cases)and a control group(36 cases)using a random number table method.The control group was treated with ornithine aspartate,while the case group was treated with probiotics combined with ornithine aspartate.The curative effect of the two groups of patients and the changes of serum inflammatory factors,intestinal flora and intestinal mucosal barrier function were observed.Results The total effective rate of the case group was higher than that of the control group[97.22%(35/36)vs 83.33%(30/36)],The difference between groups is statistically significant(χ^(2)=2.53,P=0.112).After treatment,alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),blood ammonia,interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor(TNF)in the two groups-α(TNF-α)、C-reactive protein(CRP),enterobacter,enterococcus content,endotoxin,D-lactic acid,diamine oxidase,and digital connection test(NCT)time were lower than before treatment[(-130.89±31.67)U/L vs(-98.64±43.41)U/L,(-137.81±31.92)U/L vs(-79.58±45.42)U/L,(-57.13±21.07)μmol/L vs(-45.92±18.11)μmol/L,(-164.06±19.30)μmol/L vs(-148.98±12.97)μmol/L,(-5.35±2.30)ng/L vs(2.18±2.77)ng/L,(-5.51±2.07)μmol/L vs(-3.72±1.50)ng/L,(-12.60±3.65)ng/L比(-7.97±5.86)ng/L,(-45.95±20.34)mg/L vs(-21.14±19.09)mg/L,(-2.70±1.53)vs(-1.31±2.47),(-2.50±1.26)vs(-1.39±1.97),(-0.32±0.09)EU/ml vs(-0.19±0.09)EU/ml,(-47.58±18.52)nmol/L vs(-32.31±22.21)nmol/L,(-3.44±1.06)U/ml vs(-1.86±1.30)U/ml,(-31.75±10.09)s vs(-14.58±10.10)s]and the scores of bifidobacterium,lactobacill

关 键 词：肝性脑病 微生态制剂 门冬氨酸鸟氨酸 肠道菌群 肠黏膜屏障功能 

分 类 号：R747.9[医药卫生—神经病学与精神病学] R575.2[医药卫生—临床医学]