摘要
目的观察精氨酸谷氨酸注射液治疗轻微肝性脑病(minimal hepatic encephalopathy,MHE)的疗效,同时观察精氨酸谷氨酸注射液对MHE患者肠道菌群分布的影响。方法预实验,随机选取30例MHE患者收集其粪便,同时收集30例同年龄段、同性别健康体检者的粪便,进行粪便菌群检测,分析两组患者肠道菌群分布的差异。选取2018年9月至2020年9月就诊于我院的MHE患者240例,随机分为A、B、C 3组,每组80例。在肝硬化常规治疗基础上,A组给予乳果糖口服溶液,B组给予门冬氨酸鸟氨酸注射液,C组给予精氨酸谷氨酸注射液,治疗疗程7 d。比较3组患者治疗前后数字连接试验(number connection test-A,NCT-A)、数字符号试验(digit symbol test,DST),丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天冬氨酸氨基转移酶(aspartate aminotransferase,AST)、血氨指标及肝功能Child-Pugh评分以及肠道菌群分布的变化。结果(1)预实验:与健康体检组对比,MHE患者肠道内有益菌如双歧杆菌及乳酸杆菌数量减少;有害菌如肠杆菌数量增多;有统计学差异(P<0.05);(2)与治疗前对比:3组患者NCT-A、DST、ALT、AST、血氨指标及肝功能Child-Pugh评分均改善;其中B、C两组改善程度优于A组,有统计学差异(P<0.05);而B、C两组无统计学差异(P>0.05)。B组患者肠道菌群分布未见明显改变;A、C两组患者肠道内双歧杆菌及乳酸杆菌数量增多;肠杆菌数量减少;C组改变程度优于A组,有统计学差异(P<0.05)。结论精氨酸谷氨酸注射液可改善MHE患者NCT-A、DST,ALT、AST、血氨指标及肝功能Child-Pugh评分;同时影响患者肠道菌群分布,增加肠道内有益菌数量、减少有害菌数量,有效的治疗MHE。
Objective To observe the curative effect of arginine glutamic acid injection on Minimal Hepatic Encephalopathy(MHE)and the effect of arginine glutamic acid injection on intestinal flora distribution in MHE patients.Methods In the pre-experiment,30 patients with MHE and 30 healthy people of the same age and gender were randomly selected to collect their feces for fecal flora detection,and the differences of intestinal flora distribution between the two groups were analyzed.240 MHE patients from September 2018 to September 2020 in our hospital were selected and randomly divided into group A,group B and group C,with 80 cases in each group.Based on routine treatment of liver cirrhosis,group A was given lactulose oral solution,group B was given ornithine aspartate injection,and group C was given arginine glutamate injection.The treatment course was 7 days.The changes of number connection test-A(NCT-A),digit symbol test(DST),alanine aminotransferase(ALT),aspartate aminotransferase(AST),blood ammonia index,Child-Pugh score of liver function and intestinal flora distribution were compared among the three groups before and after treatment.Results(1)Pre-experiment:Compared with the healthy group,the number of beneficial intestinal bacteria such as Bifidobacterium and Lactobacillus in MHE patients decreased;The number of harmful bacteria such as Enterobacter increased,with statistically significant difference(P<0.05);(2)Compared with pre-treatment,NCT-A,DST,ALT,AST,blood ammonia index and Child-Pugh score of liver function were improved in the three groups.The improvement degree of group B and group C was better than that of group A,with statistical difference(P<0.05).There was no statistical difference between group B and group C(P>0.05).There was no obvious change in intestinal flora distribution in group B;The number of bifidobacterium and lactobacillus in intestinal tract increased in group A and group C.The number of enterobacteriaceae decreased;The change degree of group C was better than that of group A,with statistical difference(P<0.05).Conclusion Arginine glutamate injection can improve NCT-A,DST,ALT,AST,blood ammonia index and Child-Pugh score of liver function in MHE patients.At the same time,it can affect the distribution of intestinal flora,increase the number of beneficial bacteria,reduce the number of harmful bacteria and effectively treat MHE.
作者
信红月
吴贺明
牛威
李晓飞
郭莲怡
Xin Hongyue;Wu Heming;Niu Wei;Li Xiaofei;Guo Lianyi(Jinzhou Medical University;PLA 968 Hospital;The First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000 China)
出处
《锦州医科大学学报》
2021年第4期48-52,共5页
Journal of Jinzhou Medical University
基金
辽宁省教育厅青年项目,项目编号:JYTQN2020040。
关键词
轻微肝性脑病
肠道菌群
精氨酸谷氨酸注射液
minimal hepatic encephalopathy
intestinal flora
arginine glutamic acid injection
