Department of Gastroenterology, Internal Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
Department of Gastroenterology, Shonan Kamakura General Hospital, Kamakura, Japan.
Dig Dis. 2022;40(3):313-321. doi: 10.1159/000518067. Epub 2021 Jun 28.
Data regarding the additional effect on the recurrence of hepatic encephalopathy (HE) after oral L-carnitine administration are scarce.
This study aimed to assess the additional effects of L-carnitine in patients who were receiving rifaximin for HE.
This randomized study comprised a screening visit and a 12-week treatment period. Patients who fulfilled the eligibility criteria were randomized to either group A (additional rifaximin) or group B (additional L-carnitine and rifaximin). Group A received 1,200 mg/day of rifaximin. Group B received 1,500 mg/day of L-carnitine and rifaximin at 1,200 mg/day. The endpoints were the changes in the portal systemic encephalopathy (PSE) index and the admission rate from the baseline for the duration of the study in both groups.
Eighty-three patients were randomized to either group A (n = 42) or group B (n = 41). In group A, the PSE index decreased from 0.35 ± 0.09 at baseline to 0.27 ± 0.11 on the final evaluation day (p = 0.001). In group B, the PSE index decreased from 0.37 ± 0.09 at baseline to 0.24 ± 0.11 on the final evaluation day (p = 0.001). Although there was not a significant reduction in the PSE index in group A compared to that in group B (p = 0.202), the admission rates were 30.9% and 9.8% in groups A and B, respectively. Additional L-carnitine significantly reduced the admission rate (p = 0.028).
L-Carnitine addition reduced the risk of hospitalization for patients who received rifaximin for HE.
关于口服左卡尼汀给药后对肝性脑病（HE）复发的额外影响的数据很少。
本研究旨在评估左卡尼汀对接受利福昔明治疗 HE 的患者的额外作用。
这项随机研究包括一次筛选就诊和 12 周的治疗期。符合入选标准的患者被随机分为 A 组（额外的利福昔明）或 B 组（额外的左卡尼汀和利福昔明）。A 组每天服用 1200 毫克利福昔明。B 组每天服用 1500 毫克左卡尼汀和利福昔明 1200 毫克。终点是两组在研究期间从基线开始的门静脉系统脑病（PSE）指数变化和入院率。
83 名患者被随机分为 A 组（n = 42）或 B 组（n = 41）。A 组的 PSE 指数从基线时的 0.35 ± 0.09 降至最终评估日的 0.27 ± 0.11（p = 0.001）。B 组的 PSE 指数从基线时的 0.37 ± 0.09 降至最终评估日的 0.24 ± 0.11（p = 0.001）。尽管 A 组与 B 组相比，PSE 指数的降低没有显著差异（p = 0.202），但 A 组和 B 组的入院率分别为 30.9%和 9.8%。额外的左卡尼汀显著降低了入院率（p = 0.028）。
左卡尼汀的加入降低了接受利福昔明治疗 HE 的患者住院的风险。
