ABSTRACT
Objective To investigate the effect of ornithine aspartate combined with alprostadil in the treatment of severe chronic hepatitis B (CHB),and its effect on serum tumor necrosis factor-α (TNF-α).Methods 80 patients with severe CHB were selected.The patients were divided into the observation group and the control group by digital random method,40 patients in each group.The control group was given conventional treatment of rest,isoglycyrrhizinate magnesium needle,glutathione needle,plasma,albumin,anti-hepatitis B virus.The observation group received ornithine aspartate combined with alprostadil treatment based on the treatment of the control group.After a continuous treatment of 4 weeks,the curative effect was observed,the changes of liver function before and after treatment was compared.Enzyme-linked immunosorbent assay (ELISA) was used to detect the plasma TNF-α level,and the adverse reactions during treatment were recorded.Results The total effective rate of the observation group was 92.50％,which was significantly higher than 80.00％ of the control group (x2 =26.588,P ＜ 0.05).The preoperative and postoperative alanine aminotransferase(ALT),prothrombin activity(PTA),total bilirubin (TBIL) of the two groups had statistically significant differences (all P ＜ 0.05),and,there were statistically significant differences between the observation group and the control group after treatment[(86.56 ± 38.67)U/L vs.(121.23 ± 39.65)U/L,(62.45 ±5.46)％ vs.(54.88 ±5.37) ％ and (175.67 ±42.34) μmol/L vs.(214.56 ±43.45) μmol/L,t =3.959,6.252,4.054,all P ＜ 0.001].The plasma TNF-αt level had no statistically significant difference between the two groups before treatment (P ＞ 0.05).After treatment,the TNF-α level of the two groups was significantly decreased,which of the observation group was significantly lower than that of the control group[(176.45 ± 20.41)ng/L vs.(221.43 ± 21.43)ng/L,t =9.613,P ＜ 0.001].The incidence rate of adverse reactions of the observation group was 12.50％,which had no significant difference compared with 10.00％ of the control group (x2 =0.313,P ＞ 0.05).Conclusion Ornithine aspartate combined with alprostadil in the treatment of severe CHB on the basis of the conventional treatment can apparently enhance clinical effect,improve liver function,decrease plasma TNF-α level and adverse reactions.
ABSTRACT
OBJECTIVE:To establish a method for the determination of the content and molar ratio of Ornithine aspartate for in-jection. METHODS:HPLC was performed on the column of Thermo HYPERSIL Aps-2 amino column with mobile phase of aceto-nitrile-0.05mol/L Potassium dihydrogen phosphate solution,the flow rate was 0.9 ml/min,the column temperature was 30℃,the de-tection wavelength was 200 nm,and the injection volume of 20 μl. The results determined by HPLC and potentiometric titration were compared. RESULTS:The linear range of ornithine aspartate was 0.02-10.01 mg/ml(r=0.999 9);RSDs of precision,stabili-ty and reproducibility tests were lower than 2%;recovery was 99.15%-100.15%(RSD=0.35%,n=9). The content of 3 batches of Ornithine aspartate for injection was 100.04%-100.64% and molar ratio was 0.982-0.989. The content is similar to the results de-termined by potentiometric titration with national standards. CONCLUSIONS:The method is simple,accurate,specific and sensi-tive,and suitable for the determination of the content and molar ratio of Ornithine aspartate for injection.
ABSTRACT
Objective To observe the clinical effects of ornithine aspartate (OA) and lactulose on the prevention and treatment of hepatic encephalopathy for patients with portal hypertension after modified transjugular intrahepatic portosystemic shunt (TIPS).Methods Fifty-six patients with portal hypertension were treated by modified TIPS,OA and lactulose after the operation were given,the incidence of postoperative hepatic encephalopathy and the changes of blood ammonia were observed.Patients with hepatic encephalopathy after modified TIPS accepted therapeutic dosage of OA and lactulose,and the clinical effects of combined OA and lactulose on treatment of the hepatic encephalopathy after modified TIPS and changs of blood ammonia were evaluated as well.Results Prophylactic use of combined OA and lactulose after modified TIPS,there was no hepatic encephalopathy happened in 56 patients.Hepatic encephalopathy was seen in 5 patients after discontinuation of combined OA and lactulose,the incidence rate of hepatic encephalopathy was 8.93％ (5/56).The level of blood ammonia in patients after modified TIPS was significanby higher than that before treatment [(88.2 ± 23.0) μ mol/L vs.(43.1 ± 19.2) μ mol/L,P ＜ 0.05].Five patients with hepatic encephalopathy was improved quickly after given therapeutic dosage of OA and lactulose (the average treatment time was 7 d),and the level of blood ammonia was significantly lower than before treatment [(69.1 ± 14.1) p mol/L vs.(139.2 ± 15.8) μ mol/L,P＜ 0.05].Conclusion Combined OA and lactulose can effectively prevent and treat the hepatic encephalopathy after modified TIPS,its mechanism may be associated with reduction of blood ammonia level.