Efficacy of lactulose in cirrhotic patients with subclinical hepatic encephalopathy.

Autor:	Dhiman, Radha, Sawhney, Inder, Chawla, Yogesh, Das, Gautam, Ram, Sita, Dilawari, Jang, Dhiman, R K, Sawhney, M S, Chawla, Y K, Das, G, Ram, S, Dilawari, J B
Předmět:	DISACCHARIDES CLINICAL trials COMPARATIVE studies CIRRHOSIS of the liver HEPATIC encephalopathy RESEARCH methodology MEDICAL cooperation PSYCHOLOGICAL tests RESEARCH EVALUATION research RANDOMIZED controlled trials TREATMENT effectiveness DISEASE complications DIAGNOSIS THERAPEUTICS
Zdroj:	Digestive Diseases & Sciences; Aug2000, Vol. 45 Issue 8, p1549-1552, 4p
Abstrakt:	To investigate the role of lactulose in the treatment of cirrhotic patients with subclinical hepatic encephalopathy (SHE), 40 cirrhotic patients, 33 males and 7 females, were included in the study. The diagnosis of SHE was made by quantitative psychometric tests including the number connection test (NCT), figure connection test (FCT) parts A and B, and two performance subtests of Wechsler adult intelligence scale, ie, picture completion (PC) and block design (BD) tests. SHE was diagnosed in 26 (65%) of 40 patients. Of these 26 patients, 14 patients were randomized to treatment group (lactulose 30-60 ml/day for three months, SHE-L) and 12 patients to no treatment group (no lactulose, SHE-NL). Psychometric tests were repeated in all patients in both groups and in six patients with no SHE (group NSHE, N = 14) after three months. The mean scores and number of the abnormal psychometric tests at entry were significantly higher in patients in groups SHE-L and SHE-NL than in patients in group NSHE; however, there was no significant difference between SHE-L and SHE-NL. The mean number of the abnormal psychometric tests decreased in patients in group SHE-L after three months of treatment with lactulose (2.9 +/- 0.9 vs 0.8 +/- 1.2; P = 0.004); however, there was no change in patients in group SHE-NL after three months (3.7 +/- 1.5 vs 3.5 +/- 1.3; P = NS). While SHE improved in 8 of 10 patients in group SHE-L, none of the patients in group SHE-NL improved after three months of follow-up (P < 0.001). Two patients in group SHE-NL also developed overt encephalopathy during the study period. We conclude that lactulose treatment in cirrhotic patients with SHE is effective. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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