Department of Gastroenterology, Kurashiki Central Hospital, Okayama, Japan.
Aliment Pharmacol Ther. 2010 Nov;32(9):1080-90. doi: 10.1111/j.1365-2036.2010.04448.x. Epub 2010 Sep 3.
Hepatic encephalopathy has a negative effect on patient health-related quality of life (HRQOL). Zinc supplementation has been effective with regard to altered nitrogen metabolism.
To investigate the effectiveness of oral zinc supplementation on hepatic encephalopathy and HRQOL.
Seventy-nine cirrhotic patients with hepatic encephalopathy were randomized to receive 225 mg of polaprezinc in addition to standard therapies of a protein-restricted diet including branched-chain amino acid and lactulose, or to continue only standard therapies for 6 months. The change of HRQOL by Short Form-36, hepatic encephalopathy grade, laboratory parameters, and neuropsychological (NP) tests were compared at baseline and at 6 months. We also evaluated via multivariate analysis whether zinc supplementation and clinical variables correlated with the changes in physical component scale (PCS) and mental component scale (MCS) between the two visits.
Zinc supplementation significantly improved the PCS (P = 0.04), but not the MCS (P = 0.95). Zinc supplementation significantly decreased hepatic encephalopathy grade and blood ammonia levels (P = 0.03 and P = 0.01), and improved Child-Pugh score and NP tests compared with standard therapy (P = 0.04 and P = 0.02). In multivariate analysis, zinc supplementation was significantly associated with improvement in PCS (P = 0.03), whereas it was not significantly associated with change in MCS (P = 0.98).
Zinc supplementation is effective in hepatic encephalopathy and consequently improves patients HRQOL.
肝性脑病会对患者的健康相关生活质量（HRQOL）产生负面影响。锌补充剂在改变氮代谢方面是有效的。
调查口服锌补充剂对肝性脑病和 HRQOL 的影响。
79 例肝性脑病肝硬化患者被随机分为两组，分别接受 225mg 聚普瑞锌联合标准治疗（包括限制蛋白质饮食、支链氨基酸和乳果糖）或仅接受标准治疗 6 个月。分别在基线和 6 个月时使用 36 项简明健康调查问卷（Short Form-36）、肝性脑病分级、实验室参数和神经心理学（NP）测试来比较 HRQOL 的变化。我们还通过多元分析评估了锌补充剂和临床变量是否与两次就诊之间的生理成分量表（PCS）和心理成分量表（MCS）的变化相关。
锌补充剂显著改善了 PCS（P = 0.04），但对 MCS 无显著影响（P = 0.95）。与标准治疗相比，锌补充剂显著降低了肝性脑病分级和血氨水平（P = 0.03 和 P = 0.01），并改善了 Child-Pugh 评分和 NP 测试（P = 0.04 和 P = 0.02）。多元分析表明，锌补充剂与 PCS 的改善显著相关（P = 0.03），而与 MCS 的变化无显著相关性（P = 0.98）。
锌补充剂对肝性脑病有效，因此改善了患者的 HRQOL。
