利福昔明联合乳果糖治疗肝性脑病患者疗效及其血清S100B蛋白和神经元特异性烯醇化酶变化

doi:10.3969/j.issn.1672-5069.2021.01.027

Abstract

Abstract: Objective The aim of this study was to investigate combination of rifaximin and lactulose in dealing with hepatitis B cirrhotic patients with hepatic encephalopathy (HE) and observe its clinical efficacy and mortality. Methods 74 patients with HE were admitted to our hospital between June 2015 and June 2019, and were randomly divided into two groups, with 37 cases in each. 37 patients were treated with lactulose and another 37 with lactulose and rifaximin combination for seven days. Serum S100B protein, neuron-specific enolase (NSE), C-reactive protein (CRP), tumor necrosis factor-α (TNF-), interleukin-8 (IL-8) and β-endorphin,β-EP) were assayed, and number connection test (NCT) and digital symbol test (DS) were applied for evaluation of cognition. Results The survival rate in combination group was 83.8%, significantlyhigher than 62.1% in lactulose-treated group (P<0.05); after treatment, serum CRP level in the combination group was (14.9±3.5) mg/L, much lower than , serum TNF-α level was (12.3±3.8) ng/L, significantly lower than , serum IL-8 level was (35.8±7.5) pg/mL significantly lower than , serum S100B protein level was (27.4±13.1) ng/L, significantly lower than , serum NSE level was (14.6±6.4) μg/L, significantly lower than , and plasma β-EP level was (46.7±5.3) pg/mL, significantly lower than in lactulose-treated group; serum alanine aminotransferase (ALT) level was (67.3±16.1) U/L, significantly lower than , while serum albumin (ALB) level was (35.3±7.1)g/l, significantly higher than in lactulose-treated group; the blood ammonia level was (61.7 1±1.4) μmol/L, significantly lower than in lactulose-treated group; the time of NCT was (54.3± 8.5) s, which was much shorter than , and the DS score was (58.5 ±7.2), which was significantly higher than in lactulose-treated group.Conclusion The combination of rifaximin and lactulose in the treatment of cirrhotic patients with HE could effectively inhibit the inflammatory reaction, improve liver functions, reduce stress injury, and improve cognitive functions, which might correlated to the reduction of serum S100B protein and NSE levles, and is worthy of further clinical research.

Key words: Liver cirrhosis, Hepatic encephalopathy, Rifaximin, Lactulose, Cognitive functions, Therapy

Fan Jing, Xu Jing, Yuan Xue. Combination of rifaximin and lactulose improves clinical efficacy and mortality in hepatitis B cirrhotic patients with hepatic encephalopathy[J]. Journal of Practical Hepatology, 2021, 24(1): 103-106.

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Combination of rifaximin and lactulose improves clinical efficacy and mortality in hepatitis B cirrhotic patients with hepatic encephalopathy

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