益生菌辅助治疗乙肝后肝硬化失代偿期的临床效果.docVIP

益生菌辅助治疗乙肝后肝硬化失代偿期的临床效果 　　[摘要] 目的 观察益生菌辅助治疗对乙肝后肝硬化失代偿期患者肠道黏膜通透性、血氨、内毒素及肝功能等临床指标的影响，探讨益生菌在预防肝性脑病中的作用。 方法 选择2013年9月～2015年12月浙江省立同德医院收治的乙肝后肝硬化失代偿期患者64例，按照随机数字表法分为对照组32例，观察组32例。对照组给予护肝、利尿、对症支持等常规治疗，观察组在常规治疗基础上给予益生菌制剂（商品名培菲康，双歧杆菌、嗜酸乳杆菌、粪肠球菌三联活菌，用法：420 mg/次，3次/d），分别于治疗前及治疗后检测二胺氧化酶（DAO）、血氨及内毒素水平、肝功能指标[谷丙转氨酶（ALT）、谷草转氨酶（AST）、总胆红素（TBil）、白蛋白（ALB）]和凝血功能指标[凝血酶原时间（PT）]。 结果 治疗后除对照组血氨、内毒素水平无显著变化外，两组患者治疗后DAO、ALT、AST、TBil、ALB和PT均较治疗前显著改善（P 0.05）。 结论 益生菌可通过降低乙肝后肝硬化失代偿期患者肠道黏膜通透性，降低血氨及内毒素水平，改善肝功能，从而达到预防肝性脑病的作用。 　　[关键词] 益生菌；乙型肝炎后肝硬化；血氨；内毒素；肝功能 　　[中图分类号] R575.2 [文献标识码] A [文章编号] 1673-7210（2016）07（b）-0111-04 　　[Abstract] Objective To observe the effect of probiotics on permeability of intestinal mucosa， blood ammonia， endotoxin level and hepatic function in patients with decompensation stage of HBV-related hepatic cirrhosis， and evaluate its effect in the prevention of hepatic encephalopathy. Methods A total of 64 patients with decompensation stage of HBV-related hepatic cirrhosis in Tongde Hospital of Zhejiang Province from September 2013 to December 2015 were selected. They were arranged to disparate group by random number table. 32 cases of patients in the control group were given conventional treatment， including hepatic protection drugs， diuretics therapy and other supportive treatment. Probiotics （Bifidobiogen， viable bacteria of Bifidobacterium， Lactobacillus acidophilus and Dung enterococcus， 420 mg/time， 3 times/d） was given to the 32 cases of the observation group in addition to the conventional treatment. Those indexes of diamine oxidase （DAO）， ammonia and endotoxin level， liver function （ALT， AST， ALB， TBil）， PT of coagulative function were detected before and after treatment in all patients of each group. Results After treatment， except for ammonia and endotoxin level with no significant change in the control group， the levels of DAO， ALT， AST， TBil， ALB and PT in both groups were all improved significantly compared with those before treatment （P 0.05）. Conclusion Prob