纳美芬与门冬氨酸鸟氨酸联合治疗肝性脑病的临床疗效

Therapeutic effects of nalmefene combined with L-rnithine-L-aspartate in treatment of patients with hepatic encephalopathy

目的观察纳美芬与门冬氨酸鸟氨酸联合治疗肝性脑病的疗效。方法纳入84例肝性脑病患者,随机分为对照组(门冬氨酸鸟氨酸20 g)和联合治疗组(纳美芬0.1 mg和门冬氨酸鸟氨酸10 g),均n=42。观察患者治疗前后的清醒时间、肝功能、血氨等变化。结果对照组和联合治疗组总有效率分别为54.8%和92.9%,两组比较有显著差异(P<0.05)。联合治疗组患者的清醒时间为(6.48±3.69)h,与对照组(27.11±8.21)h相比显著减少(P<0.05)。与对照组相比,联合治疗组患者的丙氨酸转氨酶、天冬氨酸转氨酶、总胆红素和血氨水平均明显降低(P<0.05)。结论纳美芬与门冬氨酸鸟氨酸联用治疗肝性脑病疗效好,优于单用门冬氨酸鸟氨酸。

AIM To investigate the effects of nalmefene combined with L- rnithine- L- aspartate in the treatment of patients with hepatic encephalopathy. METHODS Eighty-four patients with hepatic encephalopathy were divided into two groups with the principle of random sampling and serial number grouping. The control group received treatment of L-ornithinc-L-aspartate 20 g and the combination treatment group received treatment of nalmefene 0.1 mg combined with L-ornithinc-L-aspartate 10 g （n = 42 in each group）. The recovery of coma, liver function and blood ammonia before and after the treatment were observed. RESULTS The total effective rate of the control group and the combination treatment group was 54.8% and 92.9%, and the recovery of coma were （27.11 ＋ 8.21） h and （6.48 ＋ 3.69） h, respectively. There were statistically significant difference between the two groups （P 〈 0.05）. Compared with the control group, alanine aminotransferase, aspartate aminotrans-ferase, total bilirubin and blood ammonia were lower in the combination treatment group （P 〈 0.05）. CONCLUSION Nalmefene combined with L-ornithine-L-aspartate is effective in the treatment of patients with hepatic encephalopathy, better than L-ornithine-L-aspartate alone.