Michel H, Solere M, Granier P, Cauvet G, Bali J P, Pons F, Bellet-Hermann H
Gastroenterology. 1980 Aug;79(2):207-11.
It has been suggested that hepatic encephalopathy could be due to the accumulation of false neurotransmitters and that the administration of a neurotransmitter precursor such as L-dopa would be beneficial to cirrhotic patients with hepatic encephalopathy. A prospective randomized controlled study was carried out to determine whether L-dopa has any effect on the course of cirrhotic hepatic encephalopathy. L-Dopa, L-Dopa and dopa-decarboxylase inhibitor, or placebo was given orally for 7 days to 75 cirrhotic patients with hepatic encephalopathy. The effect was assessed by clinical parameters as well as serial electroencephalograms. There was no statistically significant difference with respect to clinical improvement or deterioration in patients treated with either L-dopa or L-dopa and dopa-decarboxylase inhibitor or placebo. It is concluded that L-dopa is ineffective in the treatment of cirrhotic hepatic encephalopathy. Inefficacy was not due to late onset of treatment, to poor intestinal absorption of L-dopa, to destruction of L-dopa in the blood, or to impaired passage of L-dopa into the cerebrospinal fluid.
有人提出，肝性脑病可能是由于假性神经递质的蓄积所致，并且给予神经递质前体如左旋多巴对患有肝性脑病的肝硬化患者有益。进行了一项前瞻性随机对照研究，以确定左旋多巴对肝硬化性肝性脑病的病程是否有任何影响。将左旋多巴、左旋多巴和多巴脱羧酶抑制剂或安慰剂口服给予75例患有肝性脑病的肝硬化患者，持续7天。通过临床参数以及系列脑电图评估效果。在接受左旋多巴、左旋多巴和多巴脱羧酶抑制剂或安慰剂治疗的患者中，在临床改善或恶化方面没有统计学上的显著差异。得出的结论是，左旋多巴在治疗肝硬化性肝性脑病方面无效。无效并非由于治疗开始较晚、左旋多巴肠道吸收不良、血液中左旋多巴被破坏或左旋多巴进入脑脊液的通道受损。
