实用肝脏病杂志 ›› 2026, Vol. 29 ›› Issue (1): 101-104.doi: 10.3969/j.issn.1672-5069.2026.01.026

• 肝硬化 • 上一篇    下一篇

人血白蛋白联合乳果糖和门冬氨酸鸟氨酸治疗肝硬化并发肝性脑病患者疗效研究*

肖颖, 金涛, 蒋圣君   

  1. 214200 江苏省宜兴市 江苏大学附属宜兴医院消化内科
  • 收稿日期:2025-07-10 出版日期:2026-01-10 发布日期:2026-02-04
  • 通讯作者: 蒋圣君,E-mail:13771360841@163.com
  • 作者简介:肖颖,女,34岁,医学硕士,主治医师。E-mail:xyxs1991@126.com
  • 基金资助:
    *江苏大学医教协同创新基金资助项目(编号:JDYY2023064)

Human serum albumin in combination with lactulose and ornithine aspartate in treatment of patients with liver cirrhosis and hepatic encephalopathy

Xiao Ying, Jin Tao, Jiang Shengjun   

  1. Department of Gastroenterology, Yixing Hospital Affiliated to Jiangsu University, Yixing 214200, Jiangsu Province, China
  • Received:2025-07-10 Online:2026-01-10 Published:2026-02-04

摘要: 目的 观察人血白蛋白联合乳果糖和门冬氨酸鸟氨酸治疗肝硬化并发肝性脑病(HE)患者的疗效。方法 2022年1月~2025年4月我院收治的乙型肝炎肝硬化并发HE患者58例,被随机分为对照组28例和观察组30例。所有患者在内科治疗的基础上,给予乳果糖和门冬氨酸鸟氨酸治疗。给予对照组患者人血白蛋白5 g静脉滴注,1次/d,给予观察组10 g静脉滴注,1次/d,连续治疗7~14 d。 采用ELISA法检测血清白介素(IL)-6、IL-8和C-反应蛋白(CRP)水平,采用West Haven分级评估神经功能。结果 在治疗14 d后,对照组死亡3例(10.7%),观察组死亡1例(3.3%,P>0.05);29例观察组生存患者血清总胆红素为(38.2±10.6)μmol/L,显著低于25例对照组生存【(50.1±12.7)μmol/L,P<0.05】,而血清白蛋白水平为(35.1±2.5)g/L,显著高于对照组【(33.5±2.1)g/L,P<0.05】;观察组血清IL-6、IL-8和CRP水平分别为(21.2±5.9)pg/mL、(31.4±8.7)pg/mL和(11.5±3.2)mg/L,均显著低于对照组【分别为(29.4±6.2)pg/mL、(40.5±10.9)pg/mL和(46.2±4.5)mg/L,P<0.05】;观察组West Haven 0级占比为51.7%,显著高于对照组的28.0%(P<0.05)。结论 加大人血白蛋白输注治疗肝硬化并发HE患者可有效提高血浆蛋白水平,促进昏迷患者恢复意识。

关键词: 肝硬化, 肝性脑病, 人血白蛋白, 乳果糖, 门冬氨酸鸟氨酸, 治疗

Abstract: Objective The aim of this study was to observe clinical efficacy of human serum albumin in combination with lactulose and ornithine aspartate in treatment of patients with liver cirrhosis (LC) and hepatic encephalopathy (HE). Methods 58 cirrhotics with complicated HE were enrolled in our hospital between January 2022 and April 2025, and were randomly assigned to receive intravenous human albumin 5 g daily in 28 patients in control, or receive intravenous human albumin 10 g daily in 30 patients in observation. All patients were carefully managed by internal treatment for two weeks. Serum interleukin(IL)-6, IL-8 and C-reactive protein (CRP) levels were detected by ELISA, and HE was evaluated by West Haven scoring system. Results By end of two week observation, three patients (10.7%)died in the control, and one died (3.3%, P>0.05)in the observation groups; total serum bilirubin level in 29 survivals in the observation was (38.2±10.6)μmol/L, much lower than [(50.1±12.7)μmol/L, P>0.05],while serum albumin level was (35.1±2.5)g/L, much higher than [(33.5±2.1)g/L, P<0.05)] in 25 survivals in the control; serumIL-6, IL-8 and CRP levels were (21.2±5.9)pg/mL, (31.4±8.7)pg/mL and(11.5±3.2)mg/L, all significantly lower than [(29.4±6.2)pg/mL, (40.5±10.9)pg/mL and (46.2±4.5)mg/L, respectively, P<0.05] in the control; proportion of West Haven grade 0 in the observation group was 51.7%, much higher than 28.0%(P<0.05) in the control group. Conclusion Human serum albumin infusion in dealing with LC patients with HE could improve regaining consciousness, which might be related to increased plasma colloid osmotic pressure and relatively quick liver functioning.

Key words: Liver cirrhosis, Hepatic encephalopathy, Human serum albumin, Lactulose, Ornithine aspartate, Therapy