Trovato G M, Catalano D, Carpinteri G, Runcio N, Mazzone O
Clinica Medica, Università, Catania.
Recenti Prog Med. 1995 Jul-Aug;86(7-8):299-303.
Hepatic encephalopathy in liver cirrhosis is due to several factors, including amino acid imbalance and hyperammonemia. Lactitol [correction of lactilol], a non adsorbable disaccharide, improves hepatic encephalopathy increasing bowel movements, modifying colonic bacteria and pH, and reducing blood ammonium. Ten patients with liver cirrhosis and longstanding stable hepatic encephalopathy were treated, after a period of drugs wash-out, with lactitol. A significant improvement of hepatic encephalopathy was observed, with a significant decrease of blood ammonium, related with the increase of stool frequency/day. Atrial natriuretic peptide decreased as well. Moreover, an increase of the ratio of plasma aliphatic amino acids (valine, leucine and isoleucine)/aromatic amino acid (tyrosine and phenylalanine) was observed. Lactitol is an effective drug in the treatment of chronic hepatic encephalopathy; its mechanism of action involves not only a decrease of blood ammonium but also modifications of the degree of plasma amino acid imbalance, and fluid and circulatory adjustments.
肝硬化中的肝性脑病由多种因素引起，包括氨基酸失衡和高氨血症。乳果糖（纠正：拉克替醇），一种不可吸收的二糖，通过增加排便次数、改变结肠细菌和pH值以及降低血氨来改善肝性脑病。对10例肝硬化且长期稳定的肝性脑病患者在经过一段时间的药物洗脱后用拉克替醇进行治疗。观察到肝性脑病有显著改善，血氨显著降低，这与每日排便次数增加有关。心房利钠肽也有所下降。此外，观察到血浆中支链氨基酸（缬氨酸、亮氨酸和异亮氨酸）/芳香族氨基酸（酪氨酸和苯丙氨酸）的比值增加。拉克替醇是治疗慢性肝性脑病的有效药物；其作用机制不仅包括降低血氨，还包括改变血浆氨基酸失衡程度以及体液和循环调节。
