N-乙酰半胱氨酸治疗重症肝病的多中心前瞻性临床研究

A multi-center clinical prospective study of N-acetylcysteine on severe hepatic disease

目的评估N-乙酰半胱氨酸(NAC)治疗重症肝病的疗效和安全性。方法选择各种原因引起的重症肝病230例,随机分为两组。对照组给予常规治疗,治疗组在常规治疗的基础上,给予NAC静注,4 g/d,疗程28d,于用药前及用药后21、28 d分别记录患者症状、体征、肝功生化、凝血四项以及不良反应。结果治疗组治疗后临床症状好转,ALT、AST、TBIL、PTA等均明显改善,MELD评分和Child评分均明显下降,并显著优于对照组。治疗期间未发生严重不良事件。结论NAC能明显改善重症肝病患者的临床症状和肝功能指标,无严重不良反应。

Objective To evaluate the effect and safety of N-acetylcysteine （NAC） on severe hepatic disease. Methods 230 patients with severe hepatic disease were divided into NAC group and control group. Patients in control group were treated with routine, and patients in NAC group were treated with the same therapeutic drugs used in control group plus a daily dose of 4 g NAC for 28 days. The symptom, harmful reaction, hepatic function and other biochemistry parame- ters were checked at day 0, 21 and 28. Results In NAC group, the clinical symptom and the levels of ALT, AST, TBIL, PTA were improved obviously and the MELD and child＇ marks were decreased. There was significant difference between two groups. Conclusion The NAC can improve patients＇ clinical symptom and hepatic function and shows no serious adverse effect during the treatment period.