期刊
JOURNAL OF HEPATOLOGY
卷 47, 期 2, 页码 277-283出版社
ELSEVIER
DOI: 10.1016/j.jhep.2007.03.027
关键词
alcoholic hepatitis; clinical trial; antioxidants
Background/Aims: Oxidative stress is putatively involved in the pathogenesis of alcohol-induced liver injury. This trial was devised to determine whether antioxidant therapy, alone or as an adjunct to corticosteroids, improved survival in patients with acute alcoholic hepatitis. Methods: Patients with a severe alcoholic hepatitis were stratified by sex and steroid use, and then randomized. The active group received N-acetylcysteine for one week, and vitamins A-E, biotin, selenium, zinc, manganese, copper, magnesium, folic acid and Coenzyme Q daily for 6 months. The trial was double blinded and placebo controlled. The primary end-point was mortality within 6 months. Results: Thirty-six (20 male, 16 female; mean discriminant function (DF) 86.6) received active drug, and 34 (18 male, 16 female; mean DF 76.4) received placebo. 180-day survival was not significantly different between patients receiving drug and placebo (52.8% vs. 55.8%, p = 0.699). This was not affected by stratification for steroid use or sex. The only predictors of survival in multivariate analysis were initial bilirubin (p = 0.017), white cell count (p = 0.016) and age (p = 0.037). Treatment allocation did not affect survival in multivariate analysis (p = 0.830). Conclusions:Antioxidant therapy, alone or in combination with corticosteroids, does not improve 6-month survival in severe alcoholic hepatitis. (C) 2007 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
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