CAJ | 학술논문

目的：探讨益生菌在改善乙型肝炎肝硬化轻微型肝性脑病( MHE)应用效果。方法选择2013年9月—2014年10月北京军区总医院全军肝病治疗中心确诊的乙型肝炎肝硬化MHE 60例,按治疗方法分为益生菌组和对照组各30例,两组均给予常规治疗,益生菌组在此基础上给予地衣芽孢杆菌治疗。观察两组不良反应,治疗前后血清丙氨酸转氨酶( ALT)、天冬氨酸转氨酶( AST)及血氨( NH3)水平,Child-pugh评分,数字连接试验-A( NCT-A)及临界闪烁频率( CFF)值。结果60例中有57例完成试验,两组均出现1例显性肝性脑病,对照组出现上消化道出血1例。益生菌组治疗后ALT、AST及Child-pugh评分较治疗前下降,ALT较对照组降低(P<0．05)；对照组治疗后ALT、AST较治疗前下降(P<0．05)。两组治疗后NH3、NCT-A较治疗前下降(P<0．05)；益生菌组治疗后NH3低于对照组,CFF值较治疗前和对照组升高(P<0．05)。治疗后益生菌组NCT-A及CFF阳性发生率低于对照组(P<0．05)。结论益生菌可以改善乙型肝炎肝硬化MHE患者的肝功能。
목적：탐토익생균재개선을형간염간경화경미형간성뇌병( MHE)응용효과。방법선택2013년9월—2014년10월북경군구총의원전군간병치료중심학진적을형간염간경화MHE 60례,안치료방법분위익생균조화대조조각30례,량조균급여상규치료,익생균조재차기출상급여지의아포간균치료。관찰량조불량반응,치료전후혈청병안산전안매( ALT)、천동안산전안매( AST)급혈안( NH3)수평,Child-pugh평분,수자련접시험-A( NCT-A)급림계섬삭빈솔( CFF)치。결과60례중유57례완성시험,량조균출현1례현성간성뇌병,대조조출현상소화도출혈1례。익생균조치료후ALT、AST급Child-pugh평분교치료전하강,ALT교대조조강저(P<0．05)；대조조치료후ALT、AST교치료전하강(P<0．05)。량조치료후NH3、NCT-A교치료전하강(P<0．05)；익생균조치료후NH3저우대조조,CFF치교치료전화대조조승고(P<0．05)。치료후익생균조NCT-A급CFF양성발생솔저우대조조(P<0．05)。결론익생균가이개선을형간염간경화MHE환자적간공능。
Objective To investigate the effect of probiotics in improvement of minimal hepatic encephalopathy ( MHE) in cirrhosis patients with hepatitis B virus. Methods A total of 60 cirrhosis patients with hepatitis B virus diag-nosed during September 2013 and October 2014 were divided into probiotics group (n=30) and control group (n=30) according to therapeutic methods. All the patients received conventional treatment, and probiotics group received addi-tional bacillus licheniformis treatment. The adverse reaction, and serum alanine transarninase ( ALT) , aspartate amin-otransferase ( AST) , NH3 level, Child-pugh score, and values of number connection test-A ( NCT-A) and critical flicker frequency ( CFF) before and after the therapies in the two groups were observed. Results Among the 60 patients, 57 patients completed the trial. One patient was found with overt hepatic encephalopathy ( OHE) in each group, and one pa-tient had upper gastrointestinal hemorrhage in control group. After the treatment, the ALT, AST and Child-pugh scores in probiotics group were significantly decreased compared with those before the treatment and ALT value in probiotics group was also significantly decreased than that in control group ( P<0. 05 ) . The ALT and AST values after the treatment in control group were significantly decreased (P<0. 05). The NH3 and NCT-A levels after the treatment were significantly decreased compared with those before the treatment in the two groups (P<0. 05);after the treatment, NH3 level in pro-biotics group was significantly decreased compared with that in control group, and CFF value was significantly increased in probiotics group compared with those before the treatment and in the control group (P<0. 05). The positive incidence rates of NCT-A and CFF in probiotics group were significantly lower than those in control group (P<0. 05). Conclusion Probiotics may improve the liver function of MHE in cirrhosis patients with hepatitis B virus.