乳果糖对肝硬化患者肝功能及肠黏膜屏障功能的影响

Effect of Lactulose on Liver Function and Intestinal Mucosa Barrier Function in the Patients with Liver Cirrhosis

目的:探讨乳果糖对肝硬化患者肝功能及肠黏膜屏障功能的影响。方法:64例肝硬化患者随机分为观察组33例和对照组31例,对照组患者予常规保肝、利尿和对症支持治疗,观察组在此基础上加用乳果糖口服液10 g,2～3次/d,根据大便次数适当调整乳果糖剂量使患者保持大便1～2次/d,连用6周。观察两组患者治疗前后肝功能和肠黏膜屏障功能变化。结果:治疗6周后,两组患者ALT、AST和血总胆红素(TBIL)水平均较治疗前明显下降(P<0.05或0.01),且观察组下降幅度较对照组更显著(P<0.05);治疗6周后,两组患者血浆内毒素、D-乳酸和尿乳果糖/甘露醇比值均较治疗前明显下降(P<0.05或0.01),且观察组下降幅度较对照组更显著(P<0.05)。结论:乳果糖口服液能加速肝功能恢复的作用,降低肝硬化患者肠通透性,促进肠黏膜的修复,保护与改善肠黏膜屏障功能,改善患者的预后。

Objective：To investigate the effect of lactulose on liver function and intestinal mucosa barrier function in the patients with liver cirrhosis.Method：Totally 64 cases of inpatients with liver cirrhosis were divided into the observation group and the control group.The control group was given conventional liver protective,diuretic,symptomatic and supportive treatment.The observation group was orally given lactulose 10g with 2-3 times per day for six weeks combined with the above conventional treatment,and the dosageof lactulose was adjusted by defecation times of 1-2 time per day.The changes in liver function and intestinal mucosa barrier function were observed before and after the treatment.Result：After the 6-week treatment,ALT,AST and TBIL levels of the two groups were decreased signiiicandy（P0.05 or P 0.01 ） compared with those before the treatment,and the decrease of the observation group was more obvious than that of the control group（P 0.05 ）.After the treatment,plasma endotoxin,D-lactic acid and urinary L/ M ratio in the two groups were decreased significandy as well（P 0.05 or P 0.01）,and the decrease of the observation group was also more significant than that of the control group（P 0.05）.Conclusion：Lactulose oral solution can accelerate the recovery of liver function,reduce intestinal permeability in the patients with liver cirrhosis,promote the repair of intestinal mucosa,protect and improve the barrier function of the intestinal mucosa,and improve the prognosis of the patients.