高压氧联合乳果糖及益生菌治疗对老年轻微型肝性脑病患者肝功能及认知能力的影响  

Effects of hyperbaric oxygen therapy combined with lactulose and probiotics on liver function and cognitive ability in old patients with minimal hepatic encephalopathy

作　　者：杨孜[1] 崔永辉[1] 李知翰 郑紫恒 张西亮[1] 高慧洁 Yang Zi;Cui Yonghui;Li Zhihan;Zheng Ziheng;Zhang Xiliang;Gao Huijie(Department of Gastroenterology,the First People's Hospital of Shangqiu,Shangqiu 476000,China;Department of Gastroenterology,the First Affiliated Hospital of Henan University,Kaifeng 475000,China)

机构地区：[1]商丘市第一人民医院消化内科,商丘476000 [2]河南大学第一附属医院消化内科,开封475000

出　　处：《中华航海医学与高气压医学杂志》2024年第1期69-72,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

基　　金：河南省教育厅科研课题(20A320002)。

摘　　要：目的探讨高压氧联合乳果糖及益生菌治疗对老年轻微型肝性脑病患者肝功能及认知能力的影响。方法选取2019年8月至2021年8月商丘市第一人民医院消化内科收治的92例老年轻微型肝性脑病患者作为研究对象,按照随机数字表法分为对照组(乳果糖联合益生菌治疗)与观察组(高压氧联合乳果糖及益生菌治疗),每组46例。对比2组患者的肝功能[丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、γ-谷氨酰转移酶(GGT)、总胆红素(TBil)]、认知能力[简易精神状态评价量表(MMSE)、改良长谷川痴呆量表(HDS-R)]、内毒素、血氨水平和肠道菌群(双歧杆菌、乳酸杆菌、大肠埃希菌)计数。结果与治疗前比较,治疗后2组患者的肝功能、认知能力、内毒素、血氨、肠道菌群计数明显改善(P<0.05或P<0.001);治疗后观察组患者的AST、GGT、TBil、内毒素、血氨水平和大肠埃希菌计数明显低于对照组(P<0.05或P<0.001),而认知能力评分、双歧杆菌计数高于对照组(P<0.05或P<0.01)。结论高压氧联合乳果糖及益生菌治疗有利于改善老年轻微型肝性脑病患者的肝功能和认知能力,纠正肠道菌群失调。Objective To investigate the effects of hyperbaric oxygen therapy combined with lactulose and probiotics on liver function and cognitive ability in old patients with minimal hepatic encephalopathy.Methods A total of ninety-two old patients with minimal hepatic encephalopathy admitted to the gastroenterology department of the First People's Hospital of Shangqiu from August 2019 to August 2021 were selected as the study objects,and were divided into control group(lactulose combined with probiotics)and observation group(hyperbaric oxygen therapy combined with lactulose and probiotics)by the random number table method,with 46 cases in each group.Liver function[alanine aminotransferase(ALT),aspartate aminotransferase(AST),γ-glutamyl transferase(GGT),total bilirubin(TBil)],cognitive ability[Mini-mental state examination(MMSE),revised Hasegama’s Dementia Scale(HDS-R)],endotoxin,blood ammonia,and the count of intestinal flora(bifidobacterium,lactobacillus,and escherichia coli)were compared between the two groups.Results Compared with those before treatment,liver function,cognitive ability,endotoxin,blood ammonia,and intestinal flora count of the two groups were significantly improved after treatment(P<0.05,P<0.001).After treatment,the AST,GGT,TBil,endotoxin,blood ammonia,and escherichia coli counts of the observation group were lower than those of the control group(P<0.05,P<0.001),while the score of MMSE and bifidobacterium count were higher than those of the control group(P<0.05,P<0.01).Conclusion Hyperbaric oxygen therapy combined with lactulose and probiotics can improve the liver function and cognitive ability of the elderly patients with minimal hepatic encephalopathy and correct the intestinal dysbiosis.

关 键 词：高压氧 乳果糖 益生菌 老年 轻微型肝性脑病 肝功能 认知能力 

分 类 号：R575.3[医药卫生—消化系统]