乳果糖治疗亚临床肝性脑病不同疗程的疗效观察

目的　观察乳果糖对亚临床肝性脑病 (SHE)不同疗程的疗效。方法　经数字连接试验 (NCT)和脑干听觉诱发电位 (BAEPs)诊断的SHE患者 86例 ,随机分为对照A组 2 2例 ,治疗B组 2 1例、C组 2 2例、D组 2 1例 ;对照组予常规护肝治疗 ,治疗组在对照组治疗的基础上予以乳果糖口服治疗 ,疗程分别为 4周、8周、12周 ,治疗前后每 2周予血氨、NCT和BAEPs检测。结果　疗程结束治疗组与对照组比较 ,血氨水平改善明显 (P <0 .0 1) ,BAEPs异常率降低 (P <0 .0 1) ,各组转为肝性脑病 (HE)的例数分别为A组 5例、B组 4例、C组 3例和D组 1例 ,C、D组转为HE的病例数明显少于A组 (P <0 .0 1) ;B组、C组停用乳果糖后出现了血氨上升 ,BAEPs异常率增加 ,转为HE的病例数明显多于D组。结论　乳果糖是治疗SHE的有效药物 ,长期治疗能够降低血氨 ,改善NCT ,降低HE的患病率

Efficacy of lactulose in different courses for patients with subclinical hepatic encephalopathy

Objective To observe the clinical efficacy of lactulose in different courses for patients with subclinical hepatic encephalopathy(SHE).Methods Eighty-six patients with SHE diagnosed with number connection test(NCT) were randomly allocated to control group(group A,22 cases) and lactulose treatment groups(group B,21 cases;group C,22 cases;group D 21 cases),respectively.Lactulose was given to gruop B,C,D for 4 weeks,8 weeks,12 week based on the therapy for the control group,while the latter received routine live function preserving therapy.Venous blood ammonia concentration(BA) and the brain stem auditory evoked potientials(BAEPs) and the NCT were investigated pre-and post-treatment every two weeks.Results After treatment,the blood ammonia was decreased signifigantly,the NCT and BAEPs were improved contrasted with those of control group(P< 0.01).The transfered cases in group C and group D were significantly fewer than those of group A (P< 0.01).But the patients in group B and group C at 12 weeks were worse than those of group C,the blood ammonia was increased and the abnormlities of the brainsten auditory evoked potientials were more than before.Meantimes,the development of clinical hepatic encephalopathy was more frequent in group A, group B and group C than in group D(P< 0.01).Conclusion In patients with SHE,long-term treatment with lactulose could lower BA,improve psychometric test,prevent BAEPs from being worse,and eventually reduce the occurrence rate of clinical hepatic encephalopathy.