Therapeutic efficacy of N-acetylcysteine in treatment of patients with severe liver diseases

ZHU Ting; NIE Qing-he; LI Jin-ge; CAO Yi-zhan; ZHAO Bao-min; GAO Lu-hua; WANG Yuan-yuan; LI Mi

Abstract：Objective To investigate the therapeutic efficacy and safety of N-acetylcysteine (NAC), which is regarded as the model of “gorgeous turn”of translational medicine, in treatment of patients with severe liver diseases. Methods A total of 266 patients with severe liver diseases due to HBV infection were enrolled in the study, and randomized into a treatment group (n=136, 87 with decompensated liver cirrhosis, and 49 with liver failure) and a control group (n=130, 85 with decompensated liver cirrhosis, and 45 with liver failure). All of the 266 patients were given the comprehensive treatment measures, such as maintaining hepatocyte membrane stable and hepatocyte membrane repair, antiviral therapy, rational use of antibiotics, nutritional support and the trans-fusion of fresh plasma, whole blood or albumin. Neither the treatment group nor the control group was treated with glutathione pre-paration. Additionally, the treatment group was given a daily dose of 8 g NAC for 45 days. Liver function parameters, model for end-stage liver disease (MELD) and Child-Pugh scores and adverse reactions were observed after 45 days of treatment. Results The symp-toms were improved both in the treatment group and in the control group. In the treatment group, some or all of the liver function parameters were markedly improved, and the MELD and Child-Pugh scores decreased markedly after 45 days of treatment. The improvement of the treatment group was significantly greater than that of the control group ( P<0 . 05 ) . There were no severe adverse reactions associated with NAC during treatment. Conclusions NAC can improve liver function parameters of patients with severe liver diseases markedly, and has no severe adverse reactions during treatment. NAC injection can be widely used in clinical practice.