醒脑静联合纳洛酮对肝性脑病患者相关指标的影响

摘要

目的:探讨醒脑静联合纳洛酮对肝性脑病患者相关指标的影响.方法:回顾性分析76例肝性脑病患者资料,按用药的不同分为对照组(40例)和观察组(36例).在常规治疗基础上,对照组患者给予纳洛酮注射液1 mg,加入10%葡萄糖溶液100 mL中,静脉滴注,每日2次;观察组患者在对照组治疗的基础上给予醒脑静注射液20 mL,加入0.9%氯化钠注射液250 mL中,静脉滴注,每日1次.两组疗程均为2周.观察两组患者治疗前后长谷川痴呆量表(HDS)评分、简易智力状态检查量表(MMSE)评分、血氨、β-内啡肽、C-反应蛋白(CRP)、白细胞介素6(IL-6)、IL-10、肿瘤坏死因子α(TNF-α)水平及不良反应发生情况.结果:治疗后,两组患者HDS评分、MMSE评分均显著高于同组治疗前,且观察组显著高于对照组;两组患者血氨、β-内啡肽、IL-6、CRP和TNF-α水平均显著低于同组治疗前,且观察组显著低于对照组,差异均有统计学意义(P0.05).两组患者不良反应发生率比较,差异无统计学意义(P>0.05).结论:在常规治疗的基础上,醒脑静联合纳洛酮可显著改善肝性脑病患者的认知功能,降低外周血神经毒性物质及炎症因子水平,且未增加不良反应的发生.%OBJECTIVE:To explore the effects of xingnaojing combined with naloxone on related indexes of patients with he-patic encephalopathy. METHODS:In retrospective analysis,76 patients with hepatic encephalopathy were divided into control group(40 cases)and observation group(36 cases)according to drug use. Based on routine treatment,control group was additional-ly given Naloxone injection 1 mg added into 10% Glucose solution 100 mL intravenously twice a day. Observation group was addi-tionally given Xingnaojing injection 20 mL added into 0.9% Sodium chloride injection 250 mL intravenously once a day on the ba-sis of control group. Treatment courses of 2 groups lasted for 2 weeks. HDS score,MMSE score,the levels of blood ammonia,β-endorphin,CRP,IL-6 and TNF-α,the occurrence of ADR were observed in 2 groups before and after treatment. RESULTS:Af-ter treatment,HDS score and MMSE score of 2 groups were significantly higher than before treatment,and the observation group was significantly higher than the control group;the levels of blood ammonia,β-endorphin,IL-6,CRP and TNF-α in 2 groups were significantly lower than before treatment,and the observation group was significantly lower than the control group,with statis-tical significance(P0.05). There was no statistical significantly in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Based on routine treatment,Xingnaojing combined with naloxone can significantly improve cognitive function for patients with hepatic en-cephalopathy and reduce peripheral blood neurotoxin and inflammatory factor,moreover,do not increase the incidence of ADR.