Effect of probiotic treatment on cirrhotic patients with minimal hepatic encephalopathy: A meta-analysis

查看全文 作　　者：Qing [1]Cao;Cheng-Bo [1]Yu;Shi-Gui [1]Yang;Hong-Cui [1]Cao;Ping [1]Chen;Min [1]Deng;Lan-Juan [1]Li

机构地区：[1]State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases,The First Affiliated Hospital, Zhejiang University School of Medicine

出　　处：《Hepatobiliary & Pancreatic Diseases International》索引2018年第17卷第1期,共8页

基　　金：supported by grants from the Mega-Project for National Science and Technology Development under the'11th and 12th Five-Year Plan of China'(2013ZX10004901,2013ZX10004904and 2014ZX10004008) 摘　　要：Background: Minimal hepatic encephalopathy(MHE) is an early and reversible form of hepatic encephalopathy. The documentations on the treatment with probiotics are inconsistent. The present meta-analysis was to verify the role of probiotics in the treatment of cirrhotic patients with MHE.Data sources: Seven electronic databases were searched for relevant randomized controlled trials(RCTs)published until July 2015. The effects of probiotics on serum ammonia, endotoxin, and MHE were evaluated.Results: A total of 14 RCTs(combined n = 1132) were included in the meta-analysis. When probiotics were compared to placebo or no treatment, probiotics were more likely to reduce values in the number connection test(NCT; week 4: MD =-30.25, 95% CI:-49.85 to-10.66), improve MHE(week 4: OR = 0.18,95% CI: 0.07 to 0.47; week 12: OR = 0.15, 95% CI: 0.07 to 0.32), and prevent overt HE progression(week4: OR = 0.22, 95% CI: 0.07 to 0.67) in patients with liver cirrhosis. When probiotics was compared to lactulose, probiotics tended to reduce serum ammonia levels(week 4: MD =-0.33 μmol/L, 95% CI:-5.39 to 4.74; week 8: MD = 6.22 μmol/L, 95% CI:-24.04 to 36.48), decrease NCT(week 8: MD = 3.93, 95% CI:-0.72 to 8.58), improve MHE(week 4: OR = 0.93, 95% CI: 0.45 to 1.91; week 12: OR = 0.73, 95% CI: 0.35 to 1.51) and prevent the development of overt HE(week 4: OR = 0.96, 95% CI: 0.17 to 5.44; week 12:OR = 2.7, 95% CI: 0.50 to 14.64) in patients with liver cirrhosis. However, lactulose appears to be more effective in reducing NCT values as compared to probiotics(week 4: MD = 6.7, 95% CI: 0.58 to 12.82).Conclusion: Probiotics can decrease serum ammonia and endotoxin levels, improve MHE, and prevent overt HE development in patients with liver cirrhosis. 关键词：RANDOMIZED controlled trials PROBIOTICS LACTULOSE MINIMAL hepatic ENCEPHALOPATHY

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Effect of probiotic treatment on cirrhotic patients with minimal hepatic encephalopathy: A meta-analysis

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