乳果糖治疗乙型肝炎后肝硬化内毒素血症的疗效观察

目的观察乳果糖治疗乙型肝炎后肝硬化内毒素血症的临床疗效。方法将70例乙型肝炎后肝硬化伴血清内毒素血症的患者随机分为两组，对照组35例予以常规保肝降酶退黄治疗，治疗组35例在常规保肝降酶退黄治疗的基础上加用乳果糖口服20d，分别观察两组患者在治疗前后血清内毒素水平的变化。结果乳果糖治疗组内毒素血症的复常率为85．7％，明显高于对照组45．6％（X^2=10．94，P〈0．01）。治疗组血清内毒素水平、丙氨酸氨基转氨酶（ALT）、天冬氨酸氨基转氨酶（AST）、总胆红素（TBIL）有显著下降，血清白蛋白（A）升高，显著优于对照组（P〈0．05或P〈0．01）。结论乳果糖具有显著降低乙型肝炎后肝硬化血清内毒素水平的作用，乳果糖可防治乙型肝炎后肝硬化内毒索血症。

Effect of lactulose in treating endotoxemia in patients with hepatic cirrhosis due to hepatitis B

Objective To observe the clinical efficacy of lactulose in treaing endotoxemia in patients with hepatic cirrhosis due to hepatitis B. Methods Seventy patients with hepatic cirrhosis due to hepatitis B were randomly divided into the treated group （n = 35 ） and the control group （n = 35 ）. Patients in the control group received conventional treatments for 20 days. Besides conventional treatments, patients in the treated group received lactulose for 20 days. Results In the treated group, the improvement rate of endotoxemia was 85.7%, significantly better than the control group 45.6% （X^2 = 10. 94, P 〈0.01）. Serum endotoxin, ALT,AST and TBIL were all lower in the treated group than those in the control group （P 〈 0.05 or P 〈 0.01 ）. Conclusion Lacunose can decrease the level of serum endotoxin. Lactulose is significant effective in the treatment of endotoxemia in patients with hepatic cirrhosis due to hepatitis B, and better than the control group.