Abstract
A prospective randomized trial was conducted in order to compare the efficacy of branched chain amino acid (BCAA) -enriched amino acid solution with conventional prescription of neomycin and lactulose in the treatment of hepatic encephalopathy (HE). 55 patients with 60 episodes of HE were included in the study, and most of them (70%) were patients with postnecrotic liver cirrhosis. 27 patients received conventional neomycin and lactulose plus BCAA-enriched amino acid solution 500cc (BCAA 40gm) per day in 10% dextrose solution for 5 days or till they ”woke up”. The other 28 patients received conventional treatment only were taken as the control group. Clinical and laboratory parameters including age, sex, type and stage of HE, liver function (albumin, total bilirubin, prothrombin time) and Child-Turcotte classification were not significantly different between the two groups except serum ammonia level was higher in the BCAA treated group (p＜0.05). During the trial, clinical improvement of HE, mean consciousness recovery time and hospital days of surviving patients did not show significant difference between these two groups. During BCAA-enriched amino acid solution administration, we found that the plasma concentration of aromatic amino acids (AAA) fell and the BCAA level increased, but both of these changes were not statistically significant, whlie the ratio of BCAA to AAA increased significantly (p＜0.05). It is concluded that BCAA-enriched amino acid solution administration in the dose and composition employed in the present study increased the plasma ratio of BCAA to AAA significantly but neither significantly improved cerebral function nor decreased mortality in patients with HE.
Published Version
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