Qin Huimin, Li Hongtao, Xing Mingyou, Wu Chunming, Li Guojun, Song Jianxin
Department of Infectious Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Huazhong Univ Sci Technolog Med Sci. 2006;26(2):217-20. doi: 10.1007/BF02895820.
The therapeutic effectiveness of nutritional support in the treatment of severe chronic hepatitis and posthepatitic cirrhosis was evaluated. 143 patients with severe chronic hepatitis and 83 with posthepatitic cirrhosis were evaluated with SGA for assessing the nutritional status before the treatment. Patients with severe chronic hepatitis were divided into three groups: group A subject to enteral nutrition (EN) and parenteral nutrition (PN), group B subject to comprehensive treatment (CT)+PN; group C subject to CT+EN. The patients with posthepatitic cirrhosis were divided into two groups: group D receiving CT and group E receiving CT+PN+EN. The function of liver and kidney and nutritional status were monitored to assess the therapy in 6 weeks. The results showed before treatment, over 90 % patients had moderate to severe malnutrition. After nutritional support, the liver function (ALT, T-bil) and nutritional status (TP, TC) in group A was improved significantly as compared with that in groups B and C (P<0.05). Compared with group D, the values of TP and Alb were increased significantly in group E (P<0.05), but the levels of ALT, AST and T-bil had no obvious change. It was suggested that most patients with severe chronic hepatitis or posthepatitic cirrhosis had malnutrition to varying degrees. The nutritional support treatment could obviously improve the nutritional status of these patients, and was helpful to ameliorate the liver function of the patients with severe chronic hepatitis. Among the methods of nutritional support treatment, PN combined with EN had the best effectiveness.
评估了营养支持在治疗重度慢性肝炎和肝炎后肝硬化中的疗效。对143例重度慢性肝炎患者和83例肝炎后肝硬化患者在治疗前采用主观全面评定法（SGA）评估营养状况。重度慢性肝炎患者分为三组：A组接受肠内营养（EN）和肠外营养（PN）；B组接受综合治疗（CT）+PN；C组接受CT+EN。肝炎后肝硬化患者分为两组：D组接受CT，E组接受CT+PN+EN。监测肝肾功能和营养状况以评估6周内的治疗效果。结果显示，治疗前超过90%的患者存在中度至重度营养不良。营养支持后，A组的肝功能（谷丙转氨酶、总胆红素）和营养状况（总蛋白、总胆固醇）与B组和C组相比有显著改善（P<0.05）。与D组相比，E组的总蛋白和白蛋白值显著升高（P<0.05），但谷丙转氨酶、谷草转氨酶和总胆红素水平无明显变化。提示大多数重度慢性肝炎或肝炎后肝硬化患者存在不同程度的营养不良。营养支持治疗可明显改善这些患者的营养状况，有助于改善重度慢性肝炎患者的肝功能。在营养支持治疗方法中，PN联合EN效果最佳。
