RESUMO
This paper explores the relationship between hepatic histology and conventional biochemical liver function tests in 125 chronic alcoholic patients. On the basis of the results obtained, it is suggested that abnormal biochemical liver function tests may offer important clues for further invasive investigations to establish the diagnosis of alcoholic liver disease.
Assuntos
Hepatopatias Alcoólicas/diagnóstico , Testes de Função Hepática , Fígado/patologia , Adulto , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Hepatopatias Alcoólicas/patologia , Masculino , Pessoa de Meia-IdadeRESUMO
A prospective randomized double-blind trial of 3-palmitoyl-(+)-catechin at a dose of 1500 mg daily (500 mg t.d.s.) for 3 months vs placebo has failed to demonstrate statistically significant clinical, biochemical or histological benefit in patients with biopsy-proven alcoholic liver disease. Nevertheless, this trial has confirmed the beneficial effect of a reduction in the rate of alcohol consumption on alcoholic liver disease. Apart from clinical evidence of a higher rate of alcohol consumption by patients receiving the active drug during the trial, no adverse side-effects were identified and for this reason, it is suggested that a further trial should be considered with the daily dosage so far used in man (20 mg/kg) increased toward that (100 mg/kg) employed with benefit in animal experiments.
Assuntos
Catequina/análogos & derivados , Cirrose Hepática Alcoólica/tratamento farmacológico , Consumo de Bebidas Alcoólicas/efeitos dos fármacos , Catequina/uso terapêutico , Ensaios Clínicos como Assunto , Método Duplo-Cego , Feminino , Humanos , Metabolismo dos Lipídeos , Fígado/metabolismo , Fígado/patologia , Cirrose Hepática Alcoólica/patologia , Testes de Função Hepática , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente , Estudos Prospectivos , Distribuição AleatóriaRESUMO
A prospective randomized double-blind trial of (+)-cyanidanol-3 at a dose of 2 g daily (500 mg qds) for six months versus placebo has failed to demonstrate statistically significant clinical, biochemical or histological benefit in patients with biopsy-proven alcoholic liver disease although certain trends were identified. The group receiving the active drug tended to drink more both before and during the trial and had mean serum aspartate aminotransferase (AsT) and gamma-glutamyltranspeptidase (gamma-GT) levels which were higher on admission to the trial. After the fourth week of treatment, the mean serum levels of these enzymes remained consistently lower in the group receiving the active drug. In order to reproduce the beneficial effects of the drug observed in the rat, it is suggested that further trials be conducted with the dosage so far used in man (ca. 20-40 mg/kg daily) increased toward that successfully employed in animal experiments (200 mg/kg daily).
Assuntos
Benzopiranos/uso terapêutico , Catequina/uso terapêutico , Hepatopatias Alcoólicas/tratamento farmacológico , Consumo de Bebidas Alcoólicas , Animais , Aspartato Aminotransferases/sangue , Catequina/administração & dosagem , Ensaios Clínicos como Assunto , Método Duplo-Cego , Índices de Eritrócitos , Feminino , Humanos , Hepatopatias Alcoólicas/sangue , Hepatopatias Alcoólicas/enzimologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Distribuição Aleatória , Ratos , gama-Glutamiltransferase/sangueRESUMO
CT scan measures of topographical brain changes, liver status as determined by biopsy, and clinical factors were studied in a group of detoxified chronic alcoholic patients. It was found that greater topographical brain changes were associated with greater severity of liver disease.
Assuntos
Alcoolismo/complicações , Dano Encefálico Crônico/induzido quimicamente , Hepatopatias Alcoólicas/patologia , Adulto , Alcoolismo/patologia , Biópsia por Agulha , Dano Encefálico Crônico/patologia , Feminino , Humanos , Fígado/patologia , Masculino , Tomografia Computadorizada por Raios XRESUMO
Blood vitamin status (B1, B2, B6, folic acid and B12) was assessed in 41 patients (M = 39; F = 2) with alcoholic liver disease. Biochemical evidence of thiamine deficiency was observed in all groups of patients. Deficiency of riboflavin was detected in patients with histologically normal liver but not in other groups. All the groups were found to be deficient in pyridoxal-5-phosphate--the active form of vitamin B6 (pyridoxine). Serum folate was decreased in all groups except in those with alcoholic hepatitis: red cell folate was, of course within normal limits in all the groups. Vitamin B12 levels were within normal limits in all groups except the cirrhotic one where it was raised. Clinico-biochemical implications of the findings are discussed. Biochemical changes in blood vitamin status may precede clinical manifestations of a disease process and may have prognostic value.