乳果糖对临床及亚临床肝性脑病预防作用的实验研究

Experimental Study of Prophylactic Effect of Lactulose on Hepatic Encephalopathy and Sub- clinical Hepatic Encephalopathy

目的：探讨乳果糖对临床肝性脑病（ＨＥ）及亚临床肝性脑病（ＳＨＥ）的预防作用。方法：实验组和对照组新西兰家兔各８只，于实验前行体感诱发电位（ＳＥＰ）、脑干听觉诱发电位（ＢＡＥＰ）和动脉血氨水平检查；于０及２４ｈ时经耳静脉注射肝毒性药物，并从实验开始起分别喂饲乳果糖和葡萄糖（８ｈ１次）作为ＨＥ／ＳＨＥ的预防性用药，待出现肝功能衰竭后复查ＳＥＰ、ＢＡＥＰ和动脉血氨水平。结果：出现肝功能衰竭后，实验组家兔ＳＥＰ Ｎ波潜伏期和ＢＡＥＰⅢ波、Ⅳ波潜伏期及Ⅰ－Ⅲ、 Ⅰ－Ⅳ峰间期较对照组缩短，动脉血氨水平明显下降。结论：乳果糖在急性肝功能衰竭的发生、发展过程中可以起到预防及减轻ＨＥ／ＳＨＥ的作用。

Background/Aims: To discuss the prophylactic effect of lactulose on hepatic encephalopathy (HE) and subclinical hepatic encephalopathy (SHE). Methods: There were 8 New Zealand rabbits in lac- tulose group and control group, respectively. Somatosensory evoked potentials (SEP), brainstem audi- tory evoked potentials (BAEP) and arterial blood ammonia were examined before the study. Liver toxic drug was administered intravenously at 0 and 24 hour. Lactulose or glucose was taken orally every 8 hours after the first intravenous administration for preventing HE/SHE. Evoked potentials and arte- rial blood ammonia were re-examined when the rabbits were in hepatic failure. Results: The latency of SEP N and BAEP Ⅲ,Ⅳ,Ⅰ-Ⅲ,Ⅰ-Ⅳ in the lactulose group was shorter than that in the control group. The arterial blood ammonia level in the lactulose group was lower than that in the control group. Conclusions: HE/SHE can be prevented or mitigated with lactulose during fulminant hepatic failure.