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

Abstract

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

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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