肝营养素对肝硬化肝功能失代偿期患者干预临床研究

Clinical research of liver nutrients in treating patients with decompensated liver cirrhosis

目的观察肝营养素干预对肝硬化患者血清人胰岛素样生长因子-1（IGF-1）的影响及临床疗效,探索适合肝硬化肝功能失代偿期患者的营养支持疗法。方法 2013年5~10月在河南省人民医院消化科选取符合入组标准的肝硬化患者55例,随机分为观察组（30例）和对照组（25例）。观察组患者给予肝硬化常规治疗＋肝营养素干预;对照组患者仅给予肝硬化常规治疗。观察治疗前与治疗3个月后各项生物化学指标及营养情况的变化。结果在肝营养素干预3个月后,观察组患者的血清总胆红素、白蛋白、前白蛋白、凝血酶原时间、生长激素、IGF-1水平均较治疗前和对照组改善明显（P〈0.05）;治疗组患者的营养指标肱三头肌皮褶厚度、上臂肌围、体质量指数与治疗前和对照组比较差异明显（P〈0.05）;营养不良状况、Child-Pugh分级及腹水改善情况均较治疗前和对照组患者改善明显（P〈0.05）。结论肝营养素能够改善肝硬化患者的营养不良状况,可作为肝硬化患者营养支持的常规治疗手段。

Objective To observe clinical effect of liver nutrients on insulin-like growth factor-I （ IGF-1 ） of patients with decompensated liver cirrhosis and explore proper nutrition support therapy for patients with deeompensated liver cirrhosis. Methods Fifty-five patients with cirrhosis in Department of Digestive Medicine, Henan Provincial People＇s Hospital from May 2013 to October 2013 were selected in this study. They were randomly divided into observation group（30 patients） and control group（25 patients）. The observation group was given conventional treatment and liver nutrients intervention. The control group was given conventional treatment alone. The biochemical indicators and nutrition index were observed before and alter treatment of three months. Results After liver nutrients intervened for three months, the levels of serum total bilirubin, albumin, preal- bnmin, prothrombin time, growth hormone and IGF-1 in the observation group were improved more obviously than those before treatment and in control group（ P 〈 0.05 ）. There was significant difference in the nutrition indexes including skinfold thickness of triceps muscle of arm, the upper arm circumference, body mass index between observation group and control group （ P 〈 0. 05 ） , and there was the same trend in observation group before and after treatment（ P 〈 0.05）. The condition of malnutrition, Child-Pugh classification and ascitic volumn in the observation group were improved more obviously than those before treatment and in control group（P 〈 0. 05 ）. Conclusion Liver nutrients can improve the condition of malnutrition in patients with cir- rhosis, and it can be used as a routine treatment of nutritional support for patients with liver cirrhosis.