肝硬変患者の難治性肝性脳症(lactulose無効例)に対する非吸収性抗生物質Vancomycin hydrochlorideの有効性について

書誌事項

タイトル別名
  • Therapeutic efficacy of vancomycin hydrochloride, a nonabsorbable antibiotics, on intractable (lactulose resistant) chronic hepatic encephalopathy in cirrhotic patients.

抄録

Vancomycin hydrochloride (VCM), a nonabsorbable antibiotics, which is effective against anaerobic but ineffective against aerobic gram negative rods, was administered to five cirrhotic patients with intractable portal-systemic encephalopathy (PSE) who were resistant to oral lactulose administration and develop hepatic encephalopathy in spite of the long term administration of the drug, and changes in clinical features, blood ammonia levels, electroencephalograms, and in faecal bacterial flora were examined. VCM was also administered to one cirrhotic patients in whom the lactulose administration had to be discontinued on account of the severe diarrhea which had developed during administration of the drug, even in a small amount of only 10ml per day.<br>Clinical features of hepatic encephalopathy disappeared in all cases, and electroencephalogram showed marked improvements. The study of faecal bacterial flora showed that the anaerobic gram-negative rods (chiefly Bacteroids spp) was markedly decreased to 103-6 counts per gram of stool during VCM administration, in contrast to 108-9 counts in the periods of lactulose administration. On the other hand, aerobic gram-negative bacilli counts remained in the same range of 106-109 per gram of stool in both periods of administration of lactulose and vancomycin. With regard to the correlation between ammonia levels and anaerobic gram-negative rods (chiefly Bacteroides spp), the blood ammonia levels were falling markedly with the decrease in the bacteria as the results of VCM administration. It is concluded that VCM is effective to the intractable PSE who are resistant to oral lactulose administration.

収録刊行物

詳細情報 詳細情報について

  • CRID
    1390282681371748608
  • NII論文ID
    130001065067
  • DOI
    10.11405/nisshoshi1964.83.1006
  • COI
    1:STN:280:DyaL28zgvVKntA%3D%3D
  • ISSN
    13497693
    04466586
  • PubMed
    3747231
  • 本文言語コード
    ja
  • データソース種別
    • JaLC
    • PubMed
    • CiNii Articles
  • 抄録ライセンスフラグ
    使用不可

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