乳果糖长短程治疗对亚临床肝性脑病智力测验影响的研究

目的 :对亚临床肝性脑病 (SHE)患者进行乳果糖长短程治疗 ,比较其对智力测验的影响。方法 :随机挑选 6 0名数字连接试验 (NCT)、数字符号试验 (DST)和 /或诱发电位检查异常并配合治疗的SHE患者分配入对照组、乳果糖短程治疗组及长程治疗组中 ,每组各 2 0例。对照组仅给予VitBco治疗 2 4周 ,短程治疗组另再给予口服乳果糖治疗 8周 ,长程治疗组则另再给予口服乳果糖至 2 4周。 3组均在实验开始时、第 8、16、2 4周末随访作NCT、DST、血氨检查。结果 :治疗后三组间比较在NCT、DST、血氨均有显著性差异 (P <0 .0 5 )。其中第 8周 ,长程、短程组NCT、DST均较对照组有明显改善 (P <0 .0 5 ) ,长短程组之间无明显差异 (P >0 .0 5 ) ;第 16周 ,长程组NCT、血氨均较对照组和短程组有明显改善 (P <0 .0 5 ) ,短程组和对照组之间无明显差异 (P >0 .0 5 ) ;第 2 4周 ,长程组NCT、DST、血氨均明显好于对照组和短程组 (P <0 .0 5 ) ,短程组和对照组之间无明显差异 (P >0 .0 5 )。治疗前后自身对比显示对照组血氨无明显变化 ,但NCT、DST第 8、16、2 4周逐渐变差 (均P <0 .0 5 ) ;短程组第 8周血氨、NCT、DST均明显好转 (P <0 .0 5 ) ,第 16周恢复到治疗前水平 (P >0 .0 5 ) ,第 2 4周明显差于治疗前 (P <0 .0 5 ) ;长程

The Effects of Lactulose in Psychometric Tests of Subclinical Hepatic Encephalopathy (SHE)

Objective :To compare the clinical efficacy of long term and short term lactulose treatment on the psychometric tests of SHE patients. Methods: 60 SHE patients with abnormal psychometric tests and/or evoked potentials were randomly divided into 3 groups to observe the effect of long term and short term treatment with lactulose on SHE. The patients in control group were given Vitamine Bco only for 24 weeks,the patients in short term group were administered lactulose for 8 weeks in addition to Vitamine Bco for 24 weeks,the patients in long term group were administered lactulose in addition to Vitamine Bco for 24 weeks. Psychometric tests,venous blood ammonia concentration were repeated in 8 week intevals from the beginning to the end of the research. Results: 1.After therapy,The comparison among 3 groups showed statistical significance on venous blood ammonia,NCT,DST ( P< 0.05): On week 8,the NCT and DST of the long term and short term groups were better than those of the controls ( P< 0.05). But no statistical significance had been found between the long term and short term groups ( P> 0 05). On week 16,the long term group was better than the controls and the short term group on blood ammonia,NCT ( P< 0.05). However no statistical significance was found between the controls and the short term group ( P> 0.05). On week 16,the long term group was still better than the controls and the short term group ( P< 0.05),however no statistical significance was found between the controls and the short term group ( P> 0 05). 2. The comparison before and after treatment: In controls,no statistical significance was found on blood ammonia ( P> 0 05) compared with week 0. There was statistical significance ( P< 0.05) on NCT,DST. At the 8th week,no statistical significance was shown on NCT and DST ( P> 0.05);at the 16th and the 24th weeks,statistical significance was found on NCT,DST showing much worse than before. In short term group,highly statistical significance was found on blood ammonia,NCT,DST ( P< 0.05). At the 8th week,statistical significance was found on blood ammonia,NCT and DST,which became better than before ( P< 0.05). At the 16th week,no statistical significance was shown on blood ammonia,NCT and DST ( P> 0.05),At the 24th week,statistical significance was found on blood ammonia,NCT and DST ( P< 0.05),which became worse than before. In long term group,statistical significance was found ( P< 0.01) on blood ammonia,NCT and DST. At the 8th,16th,24th weeks,higly statistical significance was found on those aspects ( P< 0.01) because they were much better than before. Conclusions: The long term treatment using lactulose could lower blood ammonia,improve psychometric tests,however the short term treatment with lactulose could not improve SHE.