Email this article Possibilities of therapeutic correction of hyperammonemia and minimal hepatic encephalopathy in patients with chronic hepatitis C at the pre-cirrhotic stage
- Authors: Buyeverov AO1,2, Bogomolov PO1, Mayev IV3, Matsievich MV4, Uvarova OV5
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Affiliations:
- M.F. Vladimirsky Moscow Regional Research Clinical Institute
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
- A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation
- Clinical Hospital of Centrosoyuz
- Hospital of Centrosoyuz of the Russian Federation
- Issue: Vol 91, No 2 (2019)
- Pages: 52-58
- Section: Editorial
- URL: https://journals.rcsi.science/0040-3660/article/view/32926
- ID: 32926
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Abstract
Aim. Study of the social consequences of cognitive disorders in minimal hepatic encephalopathy (MHE) in patients with chronic genotype 1 hepatitis C and the possibilities of their pharmacological correction with L-ornithine-L-aspartate (LOLA, Hepa-Merz). Materials and methods. The study group included 60 male patients diagnosed with chronic hepatitis C, genotype 1 with fibrosis stage F1 according to the METAVIR scale, and presented with MHE. The average age of the patients was 34.2±5.3 years. The control group included 20 healthy men aged 34.1±5.8 years without liver disease. Intermittent treatment with LOLA was given to the study group at 15 g once daily in the morning for 2 months with 2-month off-treatment intervals, with the total treatment duration of 12 months. In the course of treatment, MHE dynamics was assessed using the critical flicker fusion frequency (CFF) test and the number connecting test (NCT), as well as by serum concentrations of ammonium ion. The LOLA efficacy endpoint was the change in the frequency of violations of traffic rules (traffic code). Results and discussion. A significant decrease in the concentration of ammonium ion was observed after 5 months of treatment (135.53 and 82.9 μmol/L, p=0.002) and maintained throughout the study. The results of the CFF test significantly improved by the end of the 1st month of LOLA treatment (p=0.008), remaining at the achieved level for 9 months. The NCT parameters reached their minimum values after 5 months (p<0.001) and remained at this level throughout the study. During the study period, the frequency of traffic code violations by participants decreased from 60 to 40% (р=0.03). Conclusion. Fractional treatment with LOLA leads to a decrease in the blood concentration of ammonium ion and, consequently, to an improvement in psychometric test results and a decrease in the frequency of traffic code violations. The result achieved can have an impact on the accident rate reduction.
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##article.viewOnOriginalSite##About the authors
A O Buyeverov
M.F. Vladimirsky Moscow Regional Research Clinical Institute; I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)
Email: bcl72@yandex.ru
д.м.н., проф. каф. медико-социальной эксперитизы, неотложной и поликлинической терапии ИПО ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова»; в.н.с. отд-ния гепатологии ГБУЗ МО «МОНИКИ им. М.Ф. Владимирского» Moscow, Russia
P O Bogomolov
M.F. Vladimirsky Moscow Regional Research Clinical Instituteк.м.н., научный руководитель отд-ния гепатологии ГБУЗ МО «МОНИКИ им. М.Ф. Владимирского» Moscow, Russia
I V Mayev
A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federationд.м.н., проф., академик РАН, проректор по учебной работе ФГБОУ ВО «МГМСУ им. А.И. Евдокимова» Moscow, Russia
M V Matsievich
Clinical Hospital of Centrosoyuzк.м.н., зав. отд-нием гастроэнтерологии ООО «Клиническая больница Центросоюза» Moscow, Russia
O V Uvarova
Hospital of Centrosoyuz of the Russian Federationврач-гастроэнтеролог отд-ния терапии №2 МУ «Больница Центросоюза РФ» Moscow, Russia
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