乳糖诱导的高血症在肝硬化患者肝脏脑病的肝硬化患者
Abhinav K Rao1, Mathew J Gregoski, Ahmed Ibrahim
1Digestive Disease Research Center, Medical University of South Carolina, Charleston, SC.
Journal of clinical gastroenterology
|January 12, 2026
概括
乳糖可导致危险的高血 (HN) 在肝脑病 (HE) 患者,特别是与直肠给药. 这种情况显著增加了肝硬化患者的死亡风险.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临床药理学 临床药理学
背景情况:
- 乳糖是肝脏脑病 (HE) 常见的透性药.
- 超血 (HN) 是乳糖治疗在肝硬化患者的潜在不良影响.
- 了解乳糖诱导的HN的风险因素和结果对于患者的安全至关重要.
研究的目的:
- 为了调查肝脏脑病变 (HE) 治疗乳糖的肝硬化患者中高血血症 (HN) 的发生率和危险因素.
- 为了比较HN和没有HN的HE患者之间的死亡率.
- 确定与增加HN风险相关的特定乳糖施用方法.
主要方法:
- 从2018年1月到2023年12月对肝硬化患者进行的回顾性研究.
- 倾向性比分匹配以比较具有和没有HN的HE患者.
- 分析乳糖剂量,服用途径 (口服或直肠) 和患者的结局,包括死亡率和停留时间.
主要成果:
- 在1651名HE患者中,有106人 (6%) 在住院期间发展出高血 (HN).
- 肠道乳糖的使用是HN最强的独立预测因子 (OR=7.12,P<0.001).
- 高累积乳糖剂量 (超过5天≥485g) 和HN与显著增加的住院死亡率相关 (60%与35%,P<0.001).
结论:
- 在HE患者中,乳糖诱导的高血与高死亡率有关.
- 在HE患者中,乳糖的直肠给药可能会引起严重的安全问题.
- 在使用乳酪糖治疗肝硬化患者时,必须仔细监测和调整剂量.
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