Ahmad Irfan, Khan Anwaar A, Alam Altaf, Dilshad Akif, Butt Arshad Kamal, Shafqat Farzana, Malik Kashif, Sarwar Shahid
Department of Medicine, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan.
J Coll Physicians Surg Pak. 2008 Nov;18(11):684-7.
To determine the efficacy of L-ornithine-L-aspartate in treatment of hepatic encephalopathy.
Randomized, placebo-controlled trial.
Department of Gastroenterology and Hepatology, Sheikh Zayed Hospital, Lahore, from February to August 2005.
Cirrhotic patients with hyperammonemia and overt hepatic encephalopathy were enrolled. Eighty patients were randomized to two treatment groups, L-ornithine-L-aspartate (20 g/d) or placebo, both dissolved in 250 mL of 5% dextrose water and infused intravenously for four hours a day for five consecutive days with 0.5 g/kg dietary protein intake at the end of daily treatment period. Outcome variables were postprandial blood ammonia and mental state grade. Adverse reactions and mortality were also determined.
Both treatment groups were comparable regarding age, gender, etiology of cirrhosis, Child-Pugh class, mental state grade and blood ammonia at baseline. Although, improvement occurred in both groups, there was a greater improvement in L-ornithine-L-aspartate group with regard to both variables. Four patients in the placebo group and 2 in L-ornithine-L-aspartate group died.
L-ornithine-L-aspartate infusions were found to be effective in cirrhotic patients with hepatic encephalopathy.
确定L-鸟氨酸-L-天冬氨酸治疗肝性脑病的疗效。
随机、安慰剂对照试验。
2005年2月至8月，拉合尔谢赫扎耶德医院胃肠病学和肝病科。
纳入患有高氨血症和显性肝性脑病的肝硬化患者。80名患者被随机分为两个治疗组，即L-鸟氨酸-L-天冬氨酸组（20克/天）或安慰剂组，两组药物均溶解于250毫升5%葡萄糖水中，每天静脉输注4小时，连续5天，每日治疗结束时饮食蛋白质摄入量为0.5克/千克。观察指标为餐后血氨和精神状态分级。同时确定不良反应和死亡率。
两个治疗组在年龄、性别、肝硬化病因、Child-Pugh分级、精神状态分级和基线血氨方面具有可比性。虽然两组均有改善，但L-鸟氨酸-L-天冬氨酸组在两个观察指标上的改善更为明显。安慰剂组有4例患者死亡，L-鸟氨酸-L-天冬氨酸组有2例患者死亡。
发现L-鸟氨酸-L-天冬氨酸静脉输注对肝硬化肝性脑病患者有效。
