盐酸万古霉素成功用于治疗对乳果糖耐药的慢性肝性脑病。
Successful use of vancomycin hydrochloride in the treatment of lactulose resistant chronic hepatic encephalopathy.
作者信息
Tarao K, Ikeda T, Hayashi K, Sakurai A, Okada T, Ito T, Karube H, Nomoto T, Mizuno T, Shindo K
机构信息
Department of Medicine, Kanagawa Cancer Center Hospital, Yokohama, Japan.
出版信息
Gut. 1990 Jun;31(6):702-6. doi: 10.1136/gut.31.6.702.
Abstract
Vancomycin hydrochloride (2 g daily) was administered to 12 patients with cirrhosis and lactulose resistant portal systemic encephalopathy in a double blind crossover trial. All 12 patients showed a remarkable clinical improvement after vancomycin treatment. The mean (SE) electroencephalographic (EEG) frequency changed from 6.3 (0.2) to 8.5 (0.2) cps (p less than 0.001) and the mean arterial ammonia concentration from 152 (4) micrograms/ml to 97 (8) micrograms/ml (p less than 0.001). Their clinical condition deteriorated when treatment was switched to lactulose, returning to the previous slower EEG frequency and high arterial ammonia concentrations. Vancomycin seems to be effective in chronic portal systemic encephalopathy in patients who are not helped by lactulose alone.
摘要
在一项双盲交叉试验中，对12例患有肝硬化且对乳果糖耐药的门体性脑病患者给予盐酸万古霉素（每日2克）治疗。所有12例患者在万古霉素治疗后均显示出显著的临床改善。平均（标准误）脑电图（EEG）频率从6.3（0.2）次/秒变为8.5（0.2）次/秒（p<0.001），平均动脉血氨浓度从152（4）微克/毫升降至97（8）微克/毫升（p<0.001）。当治疗改为乳果糖时，他们的临床状况恶化，EEG频率恢复到先前较慢的水平，动脉血氨浓度升高。对于仅使用乳果糖无效的患者，万古霉素似乎对慢性门体性脑病有效。
相似文献
1
Successful use of vancomycin hydrochloride in the treatment of lactulose resistant chronic hepatic encephalopathy.盐酸万古霉素成功用于治疗对乳果糖耐药的慢性肝性脑病。
Gut. 1990 Jun;31(6):702-6. doi: 10.1136/gut.31.6.702.
2
Comparison of lactulose and neomycin in the treatment of chronic portal-systemic encephalopathy. A double blind controlled trial.乳果糖与新霉素治疗慢性门体性脑病的比较。一项双盲对照试验。
Gastroenterology. 1977 Apr;72(4 Pt 1):573-83.
3
Successful use of vancomycin hydrochloride in the treatment of lactulose-resistant chronic hepatic encephalopathy.盐酸万古霉素成功用于治疗对乳果糖耐药的慢性肝性脑病。
J Gastroenterol Hepatol. 1989;4 Suppl 1:284-6.
4
Neomycin-sorbitol and lactulose in the treatment of acute portal-systemic encephalopathy. A controlled, double-blind clinical trial.新霉素-山梨醇和乳果糖治疗急性门体性脑病：一项对照双盲临床试验
Am J Dig Dis. 1978 May;23(5):398-406. doi: 10.1007/BF01072921.
5
Lactitol in the treatment of chronic hepatic encephalopathy: an open comparison with lactulose.乳糖醇治疗慢性肝性脑病：与乳果糖的开放性比较。
Gut. 1985 Apr;26(4):415-20. doi: 10.1136/gut.26.4.415.
6
The rectal administration of lactulose.乳果糖的直肠给药。
Aust N Z J Med. 1975 Apr;5(2):137-40. doi: 10.1111/j.1445-5994.1975.tb03642.x.
7
[Hyperammoniemia and porta-caval encephalopathy in patients with cirrhosis. Personal results of lactulose treatment].[肝硬化患者的高氨血症和门体性脑病。乳果糖治疗的个人结果]
Chir Patol Sper. 1975 Apr;23(2):77-95.
8
Lactulose in the treatment of chronic portal-systemic encephalopathy. A double-blind clinical trial.乳果糖治疗慢性门体性脑病。一项双盲临床试验。
N Engl J Med. 1969 Aug 21;281(8):408-12. doi: 10.1056/NEJM196908212810803.
9
Lactitol vs. lactulose in the treatment of chronic recurrent portal-systemic encephalopathy.乳糖醇与乳果糖治疗慢性复发性门体性脑病的比较
J Hepatol. 1988 Aug;7(1):106-10. doi: 10.1016/s0168-8278(88)80513-0.
10
Lactitol versus lactulose in the treatment of acute portal systemic encephalopathy (PSE). A controlled trial.乳糖醇与乳果糖治疗急性门体性脑病（PSE）的对照试验
J Hepatol. 1987 Jun;4(3):293-8. doi: 10.1016/s0168-8278(87)80537-8.
引用本文的文献
1
Can rifaximin for hepatic encephalopathy be discontinued during broad-spectrum antibiotic treatment?在进行广谱抗生素治疗期间，用于肝性脑病的利福昔明能否停用？
World J Hepatol. 2024 Feb 27;16(2):115-119. doi: 10.4254/wjh.v16.i2.115.
2
Adolescence and the Microbiome: Implications for Healthy Growth and Maturation.青春期与微生物组：对健康生长和成熟的影响。
Am J Pathol. 2023 Dec;193(12):1900-1909. doi: 10.1016/j.ajpath.2023.07.004. Epub 2023 Sep 4.
3
New Insight Into Mechanisms of Hepatic Encephalopathy: An Integrative Analysis Approach to Identify Molecular Markers and Therapeutic Targets.肝性脑病机制的新见解：一种用于识别分子标志物和治疗靶点的综合分析方法
Bioinform Biol Insights. 2023 Feb 17;17:11779322231155068. doi: 10.1177/11779322231155068. eCollection 2023.
4
Evidence-based approach to management of hepatic encephalopathy in adults.成人肝性脑病管理的循证方法
World J Hepatol. 2022 Apr 27;14(4):670-681. doi: 10.4254/wjh.v14.i4.670.
5
Novel Agents in the Management of Hepatic Encephalopathy: A Review.肝性脑病治疗中的新型药物：综述
J Clin Transl Hepatol. 2021 Oct 28;9(5):749-759. doi: 10.14218/JCTH.2021.00102. Epub 2021 Jun 22.
6
Disturbance of the Glutamate-Glutamine Cycle, Secondary to Hepatic Damage, Compromises Memory Function.继发于肝损伤的谷氨酸-谷氨酰胺循环紊乱会损害记忆功能。
Front Neurosci. 2021 Jan 27;15:578922. doi: 10.3389/fnins.2021.578922. eCollection 2021.
7
Current state of knowledge of hepatic encephalopathy (Part V): clinical efficacy of L-ornithine-L-aspartate in the management of HE.肝性脑病的当前知识状态（第五部分）：L-鸟氨酸-L-天冬氨酸治疗肝性脑病的临床疗效
Metab Brain Dis. 2016 Dec;31(6):1365-1367. doi: 10.1007/s11011-016-9912-0. Epub 2016 Nov 12.
8
Pathophysiology, diagnosis, and management of hepatic encephalopathy.肝性脑病的病理生理学、诊断及管理
Inflammopharmacology. 2014 Dec;22(6):319-26. doi: 10.1007/s10787-014-0217-9. Epub 2014 Oct 10.
9
Clinical effects of rifaximin in patientswith hepatic encephalopathy intolerant or nonresponsive to previous lactulose treatment: An open-label, pilot study.利福昔明对先前乳果糖治疗不耐受或无反应的肝性脑病患者的临床疗效：一项开放标签的试点研究。
Curr Ther Res Clin Exp. 2004 Sep;65(5):413-22. doi: 10.1016/j.curtheres.2004.10.002.
10
Management of hepatic encephalopathy in the hospital.医院中肝性脑病的管理。
Mayo Clin Proc. 2014 Feb;89(2):241-53. doi: 10.1016/j.mayocp.2013.11.009. Epub 2014 Jan 8.
本文引用的文献
1
The electroencephalograph in liver disease.肝脏疾病中的脑电图
Lancet. 1957 Nov 2;273(7001):867-71. doi: 10.1016/s0140-6736(57)90005-3.
2
Ammonia production by intestinal bacteria: the effects of lactose, lactulose and glucose.肠道细菌产生氨：乳糖、乳果糖和葡萄糖的影响。
J Med Microbiol. 1980 May;13(2):177-91. doi: 10.1099/00222615-13-2-177.
3
Treatment of hepatic encephalopathy with metronidazole.甲硝唑治疗肝性脑病
Gut. 1982 Jan;23(1):1-7. doi: 10.1136/gut.23.1.1.
4
[Direct colorimetry of ammonia in the blood].
Saishin Igaku. 1966 Mar;21(3):622-7.
5
Lactulose in the treatment of chronic portal-systemic encephalopathy. A double-blind clinical trial.乳果糖治疗慢性门体性脑病。一项双盲临床试验。
N Engl J Med. 1969 Aug 21;281(8):408-12. doi: 10.1056/NEJM196908212810803.
6
Bacterial ureases in uraemic men.尿毒症男性体内的细菌脲酶
Lancet. 1971 Aug 21;2(7721):406-7. doi: 10.1016/s0140-6736(71)90119-x.
7
[Clinical significance of anaerobic gram-negative bacteria in hepatic encephalopathy and the therapeutic effects of vancomycin hydrochloride on hepatic encephalopathy].[厌氧革兰氏阴性菌在肝性脑病中的临床意义及盐酸万古霉素对肝性脑病的治疗作用]
Nihon Shokakibyo Gakkai Zasshi. 1985 Aug;82(8):1875-83.
8
9
Morphological effects of high dose neomycin sulphate on the small and large intestine.高剂量硫酸新霉素对小肠和大肠的形态学影响。
Acta Morphol Neerl Scand. 1986;24(3):223-34.
10
Lactulose and ammonia.乳果糖和氨。
Lancet. 1987 Dec 5;2(8571):1333. doi: 10.1016/s0140-6736(87)91224-4.
Zotero 插件