간경변증 환자에서 간성뇌증에 대한 acetyl-L-carnitine 의 약리효과

Abstract

AIM : To assess the clinical efficacy of acetyl-L-carnitine in the treatment of hepatic encephalopathy in cirrhotic patient, especially in diminishing the recurrence and reduction serum ammonia level.

Methods : We performed a randomized double-blind, placebo- controlled, cross-over study. We administered acetyl-L-carnitine to group 1 during 3 months first then placebo during later 3 months, and administering acetyl-L-carnitine to group 2 alternatively.

Results : Between January 2008 and February 2008, thirty two selected cirrhotic patients were enrolled in this study. Following randomization, the patients were divided into two groups(group 1=14, group 2=18). During administering acetyl-L-carnitine period, serum ammonia level was decreased significantly in all groups(group 1; p=0.005, group 2; p=0.001). In group 1, the first recurrence cases of hepatic encephalopathy were more than group 2(group 1=5, group 2=2), and the first recurrences were occurred during first 3 months in all groups.

Conclusion : Our study demonstrates that acetyl-L-carnitine administration reducted serum ammonia level, but not definitely diminishing the recurrence of hepatic encephalopathy.