益生菌在肝硬化轻微肝性脑病患者中的作用

The Role of Probiotics in Patients with Mild Hepatic Encephalopathy of Cirrhosis

目的探讨益生菌在肝硬化轻微肝性脑病患者中的作用。方法选择2018年3月至2018年11月西南医科大学附属医院诊断为肝硬化轻微肝性脑病患者109例,采用随机分组的方法将患者分为对照组和益生菌组,对照组给予低蛋白饮食、保肝等常规治疗,益生菌组在常规治疗的基础上给予枯草杆菌二联活菌肠溶胶囊治疗,观察两组的不良反应,治疗前后血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、血浆氨、Child-Push评分、数字连接试验(NCT)、数字符号实验(DST)、终末期肝病模型评分(MELD)。结果 109例中有101例完成实验,有8例患者失访,益生菌组中有2例出现显性肝性脑病,对照组中有2例患者出现消化道出血,2例患者死亡,3例患者出现显性肝性脑病,益生菌组在给予益生菌治疗后ALT、AST、血浆氨、Child-Push评分、终末期肝病模型评分、数字连接试验、数字符号实验均下降,差异有统计学意义(P<0. 05),与对照组相比,益生菌组血浆氨下降明显,差异有统计学意义(P<0. 05)。结论益生菌治疗可以改善轻微肝性脑病患者病情并降低血浆氨水平。

Objective To investigate the role of probiotics in patients with mild hepatic encephalopathy of cirrhosis.Methods Choose 109 patients with mild hepatic encephalopathy of cirrhosis,diagnosed in the affiliated Hospital of Southwest Medical University from March 2018 to November 2018,and the patients were divided into control group and probiotic group by random grouping. The control group was given routine treatment such as low protein diet and liver protection,and the probiotic group was treated with Bacillus subtilis enteric-coated capsule on the basis of routine treatment. Observe the adverse reactions of the two groups,serum alanine aminotransferase( ALT),aspartic acid transaminase( AST),plasma ammonia,Child-push score,Number Connection Test( NCT),Digit Symbor Test( DST) and the model for End-stage liver disease score( MELD) before and after treatment. Results In the 109 cases,101 cases were completed,and 8 patients lost their interview. 2 cases in the experimental group showed overt hepatic encephalopathy. In the control group,2 patients had gastrointestinal hemorrhage,2 patients died,and 3 patients showed overt hepatic encephalopathy. The probiotics group,after the treatment of probiotics,ALT,AST,plasma ammonia,Child-push score,MELD,NCT and DST decreased,statistically significant( P<0. 05). Compared with the control group,the plasma ammonia decreased significantly in the probiotic group,statistically significant( P<0. 05). Conclusion Probiotic therapy can improve the condition of patients with mild hepatic encephalopathy and reduce plasma ammonia level.