【摘要】 目的探讨早期给予肠内营养联合微生态制剂对肝性脑病(HE)患者肠道菌群的影响。方法将64例乙型肝炎肝硬化并发HE患者随机分成观察组32例和对照组32例。在抗昏迷治疗的基础上,给予对照组肠内营养治疗,观察组在对照组治疗的基础上给予双歧杆菌乳杆菌三联活菌片治疗。观察两组2 w。结果在观察2 w末,观察组和对照组分别死亡3例和4例;观察组生存患者粪便酵母样真菌为(3.2±0.4) CFU/g,显著低于对照组的[(3.9±0.5) CFU/g,P<0.05],需氧肠球菌和厌氧乳杆菌水平分别为(12.3±1.2)CFU/g和(9.7±0.7)CFU/g,显著高于对照组的[(9.3±1.2) CFU/g和(8.2±0.8)CFU/g,P<0.05];观察组血清内皮素、血氨、白介素-18和肿瘤坏死因子-α水平分别为(9.4±1.8) EU/mL、(75.4±10.2)μmol/L、(365.3±102.5) pg/mL和(26.3±10.7)n g/mL,显著低于对照组[(14.5±2.2) EU/mL、(109.3±5.5)μmol/L、(597.5±155.8) pg/mL和(42.8±11.2) ng/mL,P<0.05];观察组血清白蛋白、血浆前白蛋白、转铁蛋白和视黄醇结合蛋白水平分别为(35.3±3.5) g/L、(341.1±35.2) mg/L、(2.5±0.4) g/L和(41.3±5.6)μg/L,显著高于对照组[(31.7±2.9) g/L、(310.1±33.4) mg/L、(2.2±0.4) g/L和(36.8±5.2)μg/L,P<0.05]。结论早期给予肠内营养联合微生态制剂治疗可以有效改善HE患者肠道菌群失调症、抑制炎症应激反应,有利于营养的吸收和肝功能的恢复。更多还原

【Abstract】 Objection The purpose of this study was to investigate the efficacy of early administration of enteral nutrition and microecological agents in patients with hepatic encephalopathy(HE).Methods 64 patients with HE were randomly divided into observation and control group,with 32 cases in each group.The patients in control group were treated with routine therapy combined with early administration of enteral nutrition as patients awoke,while those in the observation group were treated with live bifidobacterium lactobacillus triple tablet at the base of the treatment in control group.All patients were followed-up for two weeks.Results At the end of the two-week observation,three and four patients in the control and in the observation died,respectively;the yeast-like fungi in the observation group was(3.21±0.4) CFU/g,significantly lower than(3.9±0.5) CFU/g in the control group(P<0.05),while the aerobic enterococcus and lactobacillus anaerobicus in the observation group were(12.3±1.2)CFU/g and(9.7±0.7) CFU/g,significantly higher than(9.3±1.2) CFU/g and(8.2±0.8) CFU/g in the control group(P<0.05);serum levels of endothelin,blood ammonia,interleukin-18 and tumor necrosis factor-a in the observation were(9.4±1.8) EU/mL,(75.4±10.2) μmol/L,(365.3±102.5) pg/mL and(26.3±10.7) ng/mL,significantly lower than(14.5±2.2) EU/mL,(109.3±15.5) μmol/L,(597.5±155.8) pg/mL and(42.8±11.2) ng/mL,respectively,in the control(P<0.05);serum levels of albumin,plasma proalbumin,transferrin and retinol-binding protein in the observation group were(35.3±3.5) g/L,(341.1±35.2)mg/L,(2.5±0.4) g/L and(41.3±5.6) μg/L,significantly higher than(31.7±2.9) g/L,(310.1±33.4) mg/L,(2.2±0.4) g/L and(36.8±5.2) μg/L in the control(P<0.05).Conclusion Early administration of enteral nutrition combined with microecological preparation might effectively improve intestinal flora disorders,inhibit inflammatory stress reaction,facilitate nutrient absorption,and improve liver function in patients with HE.更多还原