Secondary Prophylaxis of Hepatic Encephalopathy: An Open-Label Randomized Controlled Trial of Lactulose Versus Placebo
Secondary Prophylaxis of Hepatic Encephalopathy: An Open-Label Randomized Controlled Trial of Lactulose Versus Placebo
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DOI：
10.1053/j.gastro.2009.05.056
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发表时间：
2009-09-01
期刊：
影响因子：
29.4
通讯作者：
Sarin, Shiv Kumar
中科院分区：
文献类型：
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作者：
Sharma, Barjesh Chander;Sharma, Praveen;Sarin, Shiv Kumar
背景与目的：肝性脑病（HE）与不良预后相关。乳果糖用于治疗HE。目前尚无使用乳果糖预防HE复发的研究。方法：将HE恢复的便秘患者随机分为乳果糖组（HE-L组）和安慰剂组（HE-NL组）。通过心理测量学（数字连接测试[NCT-A和B]，如果不识字则进行图形连接测试[FCT-A和B]，数字符号测试[DST]和物体组装测试[OAT]），临界闪烁频率测试和血氨评估所有患者。主要终点是出现明显HE。结果：在300例恢复的HE患者中，140例（46.6%）符合入选标准并被纳入。心理测验结果异常的发生率很高（NCT-A，67.5%; NCT-B，62.5%; DST，70%; OAT，80%），14例患者中有10例FCT-A和B异常。临界闪烁频率为
BACKGROUND & AIMS: Hepatic encephalopathy (HE) is associated with a poor prognosis. Lactulose is used for the treatment of HE. There is no study on the prevention of recurrence of HE using lactulose. METHODS: Consecutive cirrhotic patients who recovered from HE were randomized to receive lactulose (HE-L group) or placebo (HE-NL group). All patients were assessed by psychometry (number connection test [NCT-A and B], figure connection test if illiterate [FCT-A and B], digit symbol test [DST], and object assembly test [OAT]), critical flicker frequency test, and blood ammonia at inclusion. Primary end point was development of overt HE. RESULTS: Of 300 patients with HE who recovered, 140 (46.6%) met the inclusion criteria and were included. There was a high prevalence of abnormal psychometry test results (NCT-A, 67.5%; NCT-B, 62.5%; DST, 70%; and OAT, 80%), and FCT-A and B were abnormal in 10 of 14 patients. Critical flicker frequency was