摘要
目的 探讨门冬氨酸鸟氨酸联合利福昔明治疗肝性脑病的疗效及对疾病复发的预防效果。方法 选取浙江省台州医院2018年1月至2019年1月84例肝性脑病患者作为研究对象,采用随机数字表法分为两组,每组各42例,对照组单用门冬氨酸鸟氨酸,观察组在对照组基础上加用利福昔明,比较两组患者治疗前后的血氨、谷丙转氨酶(alanine transaminase,AST)、总胆红素(total bilirubin,TBIL)水平、血清S100钙结合蛋白B(serum S100 calc-binding protein B)、β-内啡肽(β-endorphin,β-EP)水平、神经特异性烯醇化酶(transspecific enolase,NSE)和及神志、意识变化情况,并随访两组的复发情况。结果 两组治疗后血氨、ALT和TBIL水平均显著低于治疗前(P<0.05),且观察组治疗后血清中的血氨、ALT和TBIL水平显著低于对照组(P<0.05);两组治疗后血清中的S100B、β-EP及NSE的表达水平均显著低于治疗前(P<0.05),且观察组较对照组下降明显(P<0.05);观察组的神志转清醒时间、数字连接试验(digital connection test,NCT)和数字符号试验(digital symbol test,DS)水平均较治疗前明显改善(P<0.05),与对照组比较,观察组明显改善(P<0.05);观察组总有效率(95.24%)明显高于对照组(81.40%),差异有统计学意义(P<0.05);两组不良反应发生率比较(7.14%vs.4.76%),差异无统计学意义(P>0.05);两组肝性脑病复发住院率比较(0 vs.2.38%),差异无统计学意义(P>0.05)。结论 门冬氨酸鸟氨酸与利福昔明联用治疗肝性脑病能有效降低血氨浓度,提高治疗效果,对肝性脑病的转归有良好作用。
Objective To investigate the efficacy of ornithine aspartate combined with rifaximin in the treatment of hepatic encephalopathy and its preventive effect on disease recurrence.Methods A total of 84 patients with hepatic encephalopathy were randomly divided into two groups in Taizhou Hospital of Zhejiang Province from January 2018 to January 2019,42 cases per group.The control group was treated with ornithine aspartate only,and the observation group was given rifaximin on the basis of the control group.The levels of blood ammonia,alanine aminotransferase(ALT),total bilirubin(TBIL),serum S100 calc-binding protein B(S100B),β-endorphin(β-EP)and transspecific enolase(NSE),as well as changes in consciousness and consciousness were compared between the two groups before and after treatment,and the recurrence of the two groups were followed up.Results The serum ammonia,ALT and TBIL levels in both groups were significantly lower after treatment than before treatment(P<0.05),and the serum ammonia,ALT and TBIL levels in the observation group were significantly lower than those in the control group after treatment(P<0.05).The expression levels of S100B,β-EP and NSE in serum of two groups after treatment were significantly lower than before treatment(P<0.05),and the observation group was significantly lower than the control group(P<0.05).The time to wakefulness,digital connection test(NCT)and digital symbol test(DS)in observation group were significantly improved compared with before treatment(P<0.05),and compared with control group,the observation group was significantly improved(P<0.05).Compared with the control group,the total effective rate(95.24%vs.81.40%)had improved significantly in the observation group(P<0.05),the difference was statistically signifcant.There had no difference in the incidence of adverse reactions(7.14%vs.4.76%)and the recurrence hospitalization rate of hepatic encephalopathy(0 vs.2.38%)between the two groups(P>0.05).Conclusion Ornithine aspartate combined with rifaximin in the treatment of hepatic encephalopathy can effectively reduce the blood ammonia concentration,improve the treatment effect,and have a good effect on the prognosis of hepatic encephalopathy.
作者
周静静
施玲玲
颜小丹
陈依娜
ZHOU Jingjing;SHI Lingling;YAN Xiaodan;CHEN Yina(Department of Gastroenterology,Taizhou Hospital of Zhejiang Province,Taizhou 317000,Zhejiang,China;Department of Paediatrics,Taizhou Hospital of Zhejiang Province,Taizhou 317000,Zhejiang,China;Department of Gastroenterology,Yuyao People’s Hospital of Zhejiang Province,Yuyao 315400,Zhejiang,China)
出处
《中国现代医生》
2023年第18期82-86,共5页
China Modern Doctor
基金
台州市科技计划项目(1901ky18)。
关键词
肝性脑病
门冬氨酸鸟氨酸
利福昔明
血氨
复发
Hepatic encephalopathy
Ornithine aspartate
Rifaximin
Blood ammonia
Recurrence
