Vnitr Lek 2000, 46(4):199-204

[Essential phospholipids in the treatment of hepatic encephalopathy].

R Brůha, Z Marecek: I. interní klinika 1. LF UK a VFN Praha.

THE AIM: To evaluate the effect of treatment with intravenous essentiale phospholipids in patients with liver cirrhosis and hepatic encephalopathy grade III-IV.

PATIENTS AND METHODS: 12 patients with hepatic encephalopathy grade III-IV due to decompensated liver cirrhosis, age 35-67 years, were randomized to two groups: Essentiale 2.0 g i.v. daily was given to 6 patients in combination with standard therapy for 2 weeks; 6 patients had only standard therapy. The patients were followed up for 90 days. The diagnosis of hepatic encephalopathy was based on clinical examination, psychometrical tests and neurophysiological examination-EEG and evoked potentials.

RESULTS: Mean survival in the group treated with Essentiale i.v. was 50.3 days in comparison to 34.7 days in control group. P300 latencies improved significantly in the Essentiale group in comparison to control group (427.5 ms before vs 366.3 ms after treatment period in the treated group; 346.6 ms before vs 347.5 ms after treatment period in controls). Ammonia level decreased form 95 mumol/l. 5 to 49.7 mumol/l in the treated group, while in controls remained unchanged (46.5 mumol/l before vs 53.5 mumol/l after treatment period). No adverse reactions were observed during the treatment with Essentiale i.v.

CONCLUSION: Administration of Essentiale i.v. is a safe treatment of advanced liver disease. In the group of patients treated with Essentiale i.v. was observed prolonged survival, as an improvement of hepatic encephalopathy in comparison to control group.