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The clinico-metabolic changes and their correction in patients with encephalopathy in hepatic cirrhosis


Author: Ludmila Condraţchi
Degree:doctor of medicine
Speciality: 14.00.05 - Internal Diseases (with specification: Pulmonology, Gastroenterology, Hepatology, Nephrology, Functional Diagnostics and Endoscopy)
Year:2009
Scientific adviser: Valeriu Istrati
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Scientific consultant: Vlada-Tatiana Dumbrava
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution:
Scientific council:

Status

The thesis was presented on the 25 March, 2009
Approved by NCAA on the 23 April, 2009

Abstract

Adobe PDF document – 0.36 Mb / in romanian

Thesis

CZU 616.36-004-002:616.831-002

Adobe PDF document 0.70 Mb / in romanian
106 pages

Keywords

hepatic encephalopathy, hepatic cirrhosis, hepatic insufficiency, dezorientation in time, dezorientation in space, asterixis, hepatic smell, Reiten test, dissomnia, bad mood, aminoacids, Fisher index, ammoniac, Aminoplasmal Hepa, BioR, hepatoprotectors, vitamines, electroencephalogram

Summary

Our study makes an analysis of clinical, metabolic and electroencephalographic changes in patients with encephalopathy in viral C hepatic cirrhosis and their correction by means of administration of drugs, containing aminoacids with ramificated lateral chain (Aminoplasmal Hepa) and BioR – a drug, obtained via original technologies of oriental synthesis subsequent extraction, fractioning and purifying of bioactive substrat from the biomass of a cyanofite alga Spirulina Platensis (Nordst) Geitl with a high level of zinc and Acid glutamic content.

The first group included 33 patients with II-nd degree encephalopathy in viral C hepatic cirrhosis, treated with Aminoplasmal Hepa, the second group – 33 patients with II-nd degree encephalopathy in viral C hepatic cirrhosis, treated with BioR, the third group – 33 patients, treated with hepatoprotectors and vitamins, and the fourth group – 20 healthy persons.

The patients with II degree hepatic encephalopathy in viral C hepatic cirrhosis had a severe or very severe general condition, an accentuated clinical picture, unbalanced aminoacids (reduced concentration of aminoacids with ramificated lateral chain and increased concentration of aromatic aminoacids) and a 2,3-2,7 fold reduction of Fisher index (up to 1,03-1,24). On electroencephalogram there was a decrease in frequency and length of alpha wave, pathological teta and delta waves appear and their traces of registration are long.

The treatment of patients with II degree hepatic encephalopathy in viral C hepatic cirrhosis with drugs containing a ramificated lateral chain, glutamic acid, zinc lead to significant improvement of liver functions, intellectual performance and clinical picture.

Significant favourable changes were also noticed in patients treated with Aminoplasmal Hepa and BioR regarding mean values of aminoacids, biochemical tests and electroencephalographic trace.

There was a more significant improvement in clinical and metabolic changes in the group treated with Aminoplasmal Hepa and BioR compared with the group treated with hepatoprotectors and vitamins.

Considerating that fact, that administration of each of these drugs has its own advantages, it is recommended to associate the two drugs in order to acieve a better efficiency of the treatment.