文章摘要
戴丐国,伍登海,连建安,马红梅,姜斌华.微生态制剂联合肠内营养治疗肝性脑病的研究[J].中华流行病学杂志,2014,35(12):1392-1395
微生态制剂联合肠内营养治疗肝性脑病的研究
Clinical research on microecologic treatment combined enteral nutrition for hepatic encephalopathy
收稿日期:2014-09-15  出版日期:2014-12-10
DOI:10.3760/cma.j.issn.0254-6450.2014.12.018
中文关键词: 微生态制剂;肝性脑病;肠内营养;肠黏膜屏障
英文关键词: Probiotics;Hepatic encephalopathy;Enteral nutrition;Intestinal mucosal barrier
基金项目:浙江省医药卫生一般研究计划(2012KYA136)
作者单位E-mail
戴丐国 浙江中医药大学附属第二医院, 杭州 310005
浙江省肿瘤医院 
 
伍登海 浙江中医药大学附属第二医院, 杭州 310005 wudenghai2008@sina.com 
连建安 浙江中医药大学附属第二医院, 杭州 310005  
马红梅 浙江中医药大学附属第二医院, 杭州 310005  
姜斌华 浙江中医药大学附属第二医院, 杭州 310005  
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中文摘要:
      目的 观察微生态制剂联合肠内营养治疗对肝性脑病患者血清内毒素、肿瘤坏死因子α(TNF-α)、白细胞介素18(IL-18)、血氨水平及全身营养状态的影响.方法 选取60例肝性脑病患者,在常规保肝利尿等治疗基础上,随机分为3组分别给予口服培菲康加肠内营养、单纯口服培菲康、单纯静脉营养治疗,疗程均为2周.分别检测治疗前后第7天、第14天血清内毒素、TNF-α、IL-18、血氨及白蛋白水平.结果 与治疗前相比,培菲康联合肠内营养治疗能明显降低血清内毒素、TNF-α、IL-18及血氨水平,明显升高血浆白蛋白,与单用培菲康和单用静脉营养治疗相比差异有统计学意义(P<0.05).结论 微生态制剂联合肠内营养治疗能有效清除肝性脑病患者血氨、降低内毒素血症、保护肠黏膜屏障及改善机体的营养状态,是临床治疗肝性脑病安全有效方法.
英文摘要:
      Objective To evaluate the effect of microecologic treatment combined enteral nutrition on serum endotoxin,tumor necrosis factor-α (TNF-α),interleukin-18 (IL-18),blood ammonia levels and nutritional status in patients with hepatic encephalopathy. Methods 60 patients with hepatic encephalopathy were allocted randomly into 3 groups,on the basis of conventional liver protective therapy and uragogue with one group given probiotics plus enteral nutrition,one given probiotics only,and the 3rd group given intravenous nutrition. The whole course of treatment was four weeks. Serum levels of endotoxin,TNF-α,IL-18,ammonia and albumin were determined before and on the 7th and 14th day after treatment. Results The levels of serum endotoxin,TNF-α,IL-18 and blood ammonia in the combined treatment group decreased remarkably after treatment,while the level of serum albumin elevated markedly. The difference was significant at statistics as compared with the only probiotics group and intravenous nutrition group (P<0.05). Conclusion Microecologic treatment combined enteral nutrition could effectively reduce blood ammonia and serum endotoxin levels,protect intestinal mucosal barrier,as well as improve nutritional status of patients with hepatic encephalopathy,which was considered as a safe and efficient therapy.
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