Division of Hepatology, Department of Internal Medicine, Iwate Medical University, Japan.
Department of Gastroenterology, Iwate Prefectural Ninohe Hospital, Japan.
Intern Med. 2021;60(7):1027-1033. doi: 10.2169/internalmedicine.5793-20. Epub 2021 Apr 1.
The patient was a 65-year-old man with alcoholic liver cirrhosis who had been admitted to hospital 5 times for repeated and recurrent overt hepatic encephalopathy (HE) despite numerous therapies, including disaccharide, branched-chain amino acid (BCAA) formula, L-carnitine and zinc. After the additional administration of rifaximin (1,200 mg/day orally), his consciousness level was well controlled for 3 years without any adverse effects. The long-term administration of rifaximin may be useful and safe for managing recurrent overt HE, although the maintenance dosage and duration of rifaximin and safety should be evaluated in patients with ameliorated HE.
患者为 65 岁男性，患有酒精性肝硬化。尽管接受了多种治疗，包括双糖、支链氨基酸（BCAA）配方、左卡尼汀和锌，他仍因反复发作的显性肝性脑病（HE）已住院 5 次。在额外给予利福昔明（每天 1200mg 口服）后，他的意识水平在 3 年内得到了很好的控制，没有任何不良反应。利福昔明的长期应用可能对治疗反复发作的显性 HE 有用且安全，尽管对于改善后的 HE 患者，应评估利福昔明的维持剂量和时间以及安全性。
