Общая реаниматология (Sep 2019)
Neurotropic Effects of Hepatoprotectors During Alcohol Poisoning
Abstract
Purpose. To compare the efficacy of metabolic hepatoprotectors at an early stage of acute alcohol poisoning complicated by toxic hepatitis.Material and methods. 80 patients with acute alcohol poisoning complicated by toxic hepatitis who received medical treatment in the toxicology unit of the Republican Research Center of Emergency Medicine during 2015–2017 were examined. The patients were split into 3 groups. At the background of backbone therapy, patients of group I (n=30) received a hepatoprotectors on the basis of inosine, meglumine, methionine, nicotinamide, and succinic acid; patients of group II (n=20) were prescribed to receive drugs based on betaine glucuronate (glucomethamine), diethanol amine (glucodiamine), and nicotinamide ascorbate. Patients of group III (n=30) received the backbone therapy. In all patients, the concentrations of liver enzymes, bilirubin, free ammonia, blood lactate, the condition of vegetative nervous status were analyzed. Psychoastenics was examined using the MMSE score, FAB score and Reitan test.Results. After 48 hours, in group I patients, the concentration of blood lactate became almost normal, in group II patients it decreased to 2.6Ѓ}0.9 mmol/l, and in group III patients it was equal to 2.7Ѓ}0.9 mmol/l. On day 5, in patients of groups I and II the cognitive deficit was almost absent, in patients of group III the MMSE scores were 1.3-fold and 1.4-fold lower than in patients of groups I and II, respectively.Conclusion. The drug used in group I possessed increased antihypoxant properties but smaller hepatoprotective properties than the drug used in group II. When signs of toxic hepatitis are predominant it would be more preferable to use the drug applied in group II and when the signs of tissue hypoxia are predominant the drug applied in group I should be used.
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