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目的:观察乳果糖治疗亚临床型肝性脑病(SHE)的临床疗效。方法:通过对473名健康人进行数字连结试验(NCT)、数字符号试验(DST)检测,获得不同年龄、不同文化程度人群的相应正常值。对154例肝硬变病人进行上述2项智力测验,任何1项异常别诊为SHE,共发现86例SHE病人。其中,48例按常规治疗肝硬化并服用乳果糖(治疗组),38例(对照组)不用乳果糖,其他处理同治疗组。疗效判断:治疗1个月后每例患者再次行2项智力测验,有1项测验由异常转为正常则判为好转。同时进行肝功能分级(Pugh-Child改良分级法)。结果:NCT、DST好转率在治疗组分别为44.4％与60.0％,均显著高于对照组(22.9％与0％)(P<0.05),治疗组中26例智力测验恢复正常,好转率54.2％,明显高于对照组28.9％;治疗组肝功能分级构成比在治疗1个月后有所改善,但无统计学意义。结论:乳果糖对SHE有明显疗效,可作为防治SHE的一线首选药物。
Objective: To observe the clinical efficacy of lactulose in the treatment of subclinical hepatic encephalopathy (SHE). Methods: The digital normalization test (NCT) and digital sign test (DST) were performed on 473 healthy people to get the corresponding normal values of people of different ages and different education levels. Of the 154 patients with cirrhosis who underwent the above two intelligence tests, any one of the abnormalities was diagnosed as SHE, a total of 86 SHE patients were found. Among them, 48 cases of conventional treatment of cirrhosis and taking lactulose (treatment group), 38 cases (control group) without lactulose, other treatment with the treatment group. Efficacy judgment: After 1 month of treatment, each patient re-run two intelligence tests, one test from abnormal to normal is judged as a turn for the better. At the same time, liver function grading (Pugh-Child improved grading). Results: The improvement rates of NCT and DST in the treatment group were 44.4% and 60.0%, respectively, which were significantly higher than those in the control group (22.9% and 0%, P <0.05). Twenty-six intelligence tests returned to normal in the treatment group with a rate of improvement of 54.2 %, Which was significantly higher than that of the control group (28.9%). The grading of liver function in the treatment group was improved after one month of treatment, but it was not statistically significant. Conclusion: Lactulose has obvious curative effect on SHE and can be used as first-line drug for SHE prevention and treatment.