醒脑静联合纳洛酮对乙型肝炎肝硬化并发肝性脑病患者血氨水平及认知障碍的影响

肝脏 ›› 2025, Vol. 30 ›› Issue (4): 525-528.

醒脑静联合纳洛酮对乙型肝炎肝硬化并发肝性脑病患者血氨水平及认知障碍的影响

米兰, 王艳川, 周礼琼

725000 陕西安康市高新医院药剂科(米兰,周礼琼); 719300 神木市医院药剂科(王艳川)

收稿日期:2024-06-03 出版日期:2025-04-30 发布日期:2025-06-17
通讯作者: 王艳川,Email:13891277815@163.com
基金资助:
陕西省自然科学基础研究计划项目(2020JM-406)

Effects of xingnaojing combined with naloxone on blood ammonia level and cognitive impairment in patients with hepatitis B cirrhosis complicated with hepatic encephalopathy

MI Lan¹, WANG Yan-chuan², ZHOU Li-qiong¹

1. Department of Pharmacy, Ankang High tech Hospital, Shaanxi 725000, China;
2. Department of Pharmacy, Shenmu City Hospital, Shaanxi 719300, China

Received:2024-06-03 Online:2025-04-30 Published:2025-06-17
Contact: WANG Yan-chuan,Email:13891277815@163.com

摘要/Abstract

摘要： 目的探讨醒脑静联合纳洛酮在乙型肝炎肝硬化并发肝性脑病(HE)患者的应用价值,并分析其对患者血氨水平及认知障碍的影响。方法回顾性纳入2018年10月—2023年6月期间安康市高新医院诊治的乙型肝炎肝硬化并发肝性脑病患者150例。采用ELISA法检测血清炎症因子水平;检测血生化指标、血氨水平。比较两组治疗前后肝功能、血氨水平、内毒素、胆红素、总蛋白与白蛋白水平、血清炎症因子水平、认知功能。结果治疗后观察组的ALT、AST以及血氨水平分别为(37.1±7.3)U/L、(74.4±9.8)U/L、(78.1±9.3)μmol/L,均低于对照组[(51.2±7.5)U/L、(84.7±11.0)U/L、(112.0±12.6)μmol/L,P<0.05]。治疗后观察组内毒素水平为(1.2 ± 0.2),低于对照组(2.0 ± 0.6),总蛋白与白蛋白水平分别为(7.2 ± 0.8)g/dL、(3.7 ± 0.4)g/dL,均高于对照组[(5.6 ± 0.5)g/dL、(2.2 ± 0.7)g/dL,P<0.05]。治疗后观察组IL-6、TNF-α、β-内啡肽分别为(11.3±4.5)ng/L、(11.1±3.8)μmol/L、(41.2±5.3)pg/mL,均低于对照组[(15.3±4.2)ng/L、(14.9±4.7)μmol/L、(50.6±6.5)pg/mL,P<0.05]。观察组蒙特利尔认知评估量表(MoCA)评分为(25.0±1.2)分,高于对照组[(20.5±1.1)分,P<0.05]。结论醒脑静联合纳洛酮可有效改善 HE、血氨水平,提高患者的认知功能。

关键词: 肝硬化, 肝性脑病, 认知障碍, 联合用药

Abstract: Objective To investigate the value of waking up the brain combined with naloxone in patients with hepatitis B cirrhosis complicated with minimal hepatic encephalopathy (MHE), and to analyze the effects on patients' blood ammonia level and cognitive impairment. Methods 150 patients with hepatitis B cirrhosis complicated with hepatic encephalopathy diagnosed and treated in our hospital between October 2018 and June 2023 were retrospectively included. Serum inflammatory factor levels were detected by ELISA method; dected blood biochemical indexes and blood ammonia levels. The following parameters were compared between groups: (1) pretreatment liver function and blood ammonia levels; (2) endotoxin, bilirubin, total protein, serum inflammatory factors, and albumin levels before and after treatment; (3) cognitive function. Results The ALT, AST, and blood ammonia levels in the observation group after treatment were (37.1±7.3) U/L, (74.4±9.8) U/L, and (78.1±9.3) μmol/L, respectively, which were lower than those in the control group [(51.2±7.5) U/L, (84.7±11.0) U/L, and (112.0±12.6) μmol/L, P<0.05]. After treatment, the endotoxin level of the observation group was (1.2 ± 0.2), lower than that of the control group (2.0 ± 0.6), and the total protein and albumin levels were higher than those of the control group [(5.6 ± 0.5) g/dL, (2.2 ± 0.7) g/dL, P<0.05], at (7.2 ± 0.8) g/dL and (3.7 ± 0.4) g/dL, respectively. After treatment, IL-6, TNF-α, and β-endorphin in the observation group were (11.3±4.5) ng/L, (11.1±3.8) μmol/L, and (41.2±5.3) pg/mL, lower than those in the control group [(15.3±4.2) ng/L, (14.9±4.7) μmol/L, and (50.6±6.5) pg/mL, respectively, P<0.05]. The Montreal Cognitive Assessment Scale (MoCA) score of the observation group was (25.0 ± 1.2), which was higher than that of the control group [(20.5 ± 1.1), P<0.05]. Conclusion Wake-up call combined with naloxone can effectively improve MHE, blood ammonia levels, and cognitive function of patients.

Key words: Liver cirrhosis, Hepatic encephalopathy, Cognitive impairment, Drug combinations

米兰, 王艳川, 周礼琼. 醒脑静联合纳洛酮对乙型肝炎肝硬化并发肝性脑病患者血氨水平及认知障碍的影响[J]. 肝脏, 2025, 30(4): 525-528.

MI Lan, WANG Yan-chuan, ZHOU Li-qiong. Effects of xingnaojing combined with naloxone on blood ammonia level and cognitive impairment in patients with hepatitis B cirrhosis complicated with hepatic encephalopathy[J]. Chinese Hepatolgy, 2025, 30(4): 525-528.

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