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目的观察乳果糖治疗乙型肝炎后肝硬化内毒素血症的临床疗效。方法将70例乙型肝炎后肝硬化伴血清内毒素血症的患者随机分为两组,对照组35例予以常规保肝降酶退黄治疗,治疗组35例在常规保肝降酶退黄治疗的基础上加用乳果糖口服20 d,分别观察两组患者在治疗前后血清内毒素水平的变化。结果乳果糖治疗组内毒素血症的复常率为85.7%,明显高于对照组45.6%(x~2=10.94,P<0.01)。治疗组血清内毒素水平、丙氨酸氨基转氨酶(ALT)、天冬氨酸氨基转氨酶(AST)、总胆红素(TBIL)有显著下降,血清白蛋白(A)升高,显著优于对照组(P<0.05或P<0.01)。结论乳果糖具有显著降低乙型肝炎后肝硬化血清内毒素水平的作用,乳果糖可防治乙型肝炎后肝硬化内毒素血症。
Objective To observe the clinical efficacy of lactulose in treatment of liver cirrhosis and endotoxemia after hepatitis B infection. Methods Seventy patients with post-hepatitis B cirrhosis accompanied by serum endotoxemia were randomly divided into two groups. 35 cases in the control group were given conventional liver-protection, On the basis of the treatment, lactulose was added orally for 20 days to observe the change of serum endotoxin levels in both groups before and after treatment. Results The rate of normalization of endotoxemia in lactulose treatment group was 85.7%, which was significantly higher than that in control group (45.6%, x ~ 2 = 10.94, P <0.01). Serum endotoxin levels, ALT, AST and TBIL in treatment group were significantly decreased, while serum albumin (A) level was significantly higher in treatment group than in control group Group (P <0.05 or P <0.01). Conclusion Lactulose can significantly reduce the level of serum endotoxin in cirrhotic patients with hepatitis B, and lactulose can prevent post-hepatitis B cirrhosis endotoxemia.