摘要
目的:探讨门冬氨酸鸟氨酸联合纳洛酮对肝性脑病患者认知功能、预后及神经肽类水平的影响.方法:102例肝性脑病患者随机分为研究组和对照组,每组各51例患者.对照组患者应用常规治疗方案,研究组患者在常规治疗的基础上加用门冬氨酸鸟氨酸联合纳洛酮进行治疗.评估两组患者治疗后的认知功能改变情况,观察两组患者的总有效率、神智清醒时间,同时测定治疗前后的肝功能指标、血氨浓度以及神经肽类的变化水平.结果:(1)研究组患者治疗后的总有效率显著高于对照组的,差异有统计学意义(86.27%vs68.63%,P<0.05);(2)研究组治疗后血氨水平明显低于对照组,差异有统计学意义(52.01μmol/L±7.49μmol/L vs 75.44μmol/L±5.86μmol/L,P<0.01);(3)治疗后,两组患者肝功能指标均显著好转.研究组ALT、γ谷氨酰转移酶和总胆红素水平均明显低于对照组,差异有统计学意义(38.5 U/L±5.8 U/L vs 55.3 U/L±4.4 U/L,149.3 U/L±19.2 U/L vs 174.2 U/L±23.6 U/L,65.6μmol/L±10.8μmol/L vs 81.3μmol/L±12.9μmol/L,均P<0.01);(4)治疗后,研究组神志清醒时间明显低于对照组(7.53 h±2.68 h vs 21.02 h±9.83 h,P<0.05),MMSE评分、HDS-R评分均明显高于对照组(22.09±2.41 vs 17.76±2.02,24.11±4.12 vs 16.18±3.19,P<0.05);(5)治疗后,两组患者的精氨酸加压素、β-内啡肽相比治疗前均明显下降.研究组治疗后精氨酸加压素、β-内啡肽相比对照组明显下降,两组相比差异有统计学意义(11.28 pg/mL±2.08 pg/mL vs 15.35 pg/mL±1.65 pg/mL,42.02 pg/mL±7.66 pg/mL vs53.66 pg/mL±6.81 pg/mL,均P<0.01).
AIM： To investigate the effect of combination therapy with ornithine aspartate plus naloxone on cognitive function, prognosis, and neuropeptide levels in patients with hepatic encephalopathy.METHODS： One hundred and two patients diagnosed with hepatic encephalopathy were randomly divided into two equal groups： a control group（n = 51） and a study group（n = 51）. The control group received traditional medical treat-ment, and the research group was additionally given combination therapy with ornithine aspartate plus naloxone on the basis of traditional medical treatment. The cognitive function of the patients was assessed. The response rate and time duration from coma to consciousness were recorded. Changes in blood ammonia level, markers of liver function, and neuropeptide levels were measured by standard biochemical assays. RESULTS： The response rate was significantly higher in the study group than in the control group（86.27% vs 68.63%, P〈0.05）. After treatment, the level of blood ammonia in both groups was decreased（P〈0.05）. The level of blood ammonia in the study group was significantly lower than that in the control group（52.01 μmol/L ± 7.49 μmol/L vs 75.44 μmol/L ± 5.86 μmol/L, P〈0.01）. The liver function markers in the two groups were also significantly improved after treatment（P〈0.05）. The levels of alanine aminotransferase, gamma glutamine transferase and total bilirubin in the study group were significantly lower than those in the control group（38.5 U/L ± 5.8 U/L vs 55.3 U/L ± 4.4 U/L, 149.3 U/L ± 19.2 U/L vs 174.2 U/L ± 23.6 U/L, 65.6 μmol/L ± 10.8 μmol/L vs 81.3 μmol/L ± 12.9 μmol/L, P〈0.01）. After treatment, the time duration from coma to consciousness in the study group was significantly lower than in the control group（7.53 h ± 2.68 h vs 21.02 h ± 9.83 h, P〈0.05）. The MMSE and HDS-R scores in the study group were significantly higher than those in the control group（22.09 ± 2.41 vs 17.76 ± 2.02, 24.11 ± 4.12 vs 16.18 ± 3.19, P〈0.05）. After treatment, the levels of arginine vasopressin and beta-endorphin in both groups were decreased（P〈0.05）. The levels of arginine vasopressin and betaendorphin in the study group were significantly lower than those in the control group（11.28 pg/mL ± 2.08 pg/mL vs 15.35 pg/mL ± 1.65 pg/mL, 42.02 pg/mL ± 7.66 pg/mL vs 53.66 pg/mL ± 6.81 pg/mL, P〈0.01）. CONCLUSION： Ornithine aspartate combinedwith naloxone can improve cognitive function in patients with hepatic encephalopathy, and the treatment effect is superior compared to conventional treatment.
出处
《世界华人消化杂志》
CAS
北大核心
2014年第18期2612-2616,共5页
World Chinese Journal of Digestology
关键词
门冬氨酸鸟氨酸
纳洛酮
肝性脑病
神经肽
认知功能
Ornithine aspartate
Naloxone
Hepatic encephalopathy
Neuropeptide
Cognitive function
