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[目的]探讨乳果糖对非酒精性脂肪性肝炎(NASH)患者肝功能、血清内毒素和前降钙素(PCT)水平的影响。[方法]将84例NASH患者随机分为对照组和观察组。对照组患者予以控制饮食与适当的体育锻炼及常规保肝治疗,观察组患者予以乳果糖口服液10ml,2~3次/d,根据大便次数调整乳果糖用量使保持大便1~2次/d,连用8周。观察2组患者治疗前后肝功能、血清内毒素和PCT水平的变化,并比较其不良反应。[结果]治疗8周后,2组患者肝功能指标ALT、AST和GGT水平较前均有不同程度下降(P<0.05或P<0.01),且观察组下降幅度明显大于对照组(P<0.05);2组患者血清内毒素和PCT水平较前均有不同程度的下降(P<0.05或P<0.01),且观察组下降幅度明显大于对照组(P<0.05)。对照组和观察组出现分别不良反应2例和4例,症状较轻,2组患者不良反应发生率比较差异无统计学意义。[结论]乳果糖能降低血清内毒素和PCT水平,抑制肠源性内毒素血症的产生,保护肠黏膜屏障功能,改善其肝功能指标,辅助治疗NASH具有较好的治疗效果及安全性。
[Objective] To investigate the effect of lactulose on liver function, serum endotoxin and procalcitonin (PCT) in patients with non-alcoholic steatohepatitis (NASH). [Methods] 84 patients with NASH were randomly divided into control group and observation group. Patients in the control group were controlled diet and appropriate physical exercises and conventional liver protection treatment group patients were given lactulose oral solution 10ml, 2 to 3 times / d, according to the stool frequency adjusted lactulose dosage to keep stool 1 or 2 times / d , Used in conjunction for 8 weeks. The changes of liver function, serum endotoxin and PCT levels in two groups before and after treatment were observed, and their adverse reactions were compared. [Results] After 8 weeks of treatment, the levels of ALT, AST and GGT of liver function decreased significantly in both groups (P <0.05 or P <0.01), and the decreasing extent in the observation group was significantly greater than that in the control group (P <0.05 ). Serum endotoxin and PCT levels in both groups decreased to some extent (P <0.05 or P <0.01), and the decrease in the observation group was significantly greater than that in the control group (P <0.05). There were 2 adverse reactions and 4 mild adverse reactions in the control group and observation group, respectively. There was no significant difference in the incidence of adverse reactions between the two groups. [Conclusion] Lactulose can reduce serum endotoxin and PCT levels, inhibit the production of enterogenous endotoxemia, protect the intestinal mucosal barrier function, improve the liver function index, adjuvant treatment of NASH has good therapeutic effect and safety.