The effect of acetaminophen (four grams a day for three consecutive days) on hepatic tests in alcoholic patients--a multicenter randomized study.
The effect of acetaminophen (four grams a day for three consecutive days) on hepatic tests in alcoholic patients--a multicenter randomized study.
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DOI：
10.1186/1741-7015-5-13
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发表时间：
2007-05-30
期刊：
影响因子：
9.3
通讯作者：
Dart, R. C.
中科院分区：
文献类型：
--
作者：
Kuffner, E. K.;Green, J. L.;Bogdan, G. M.;Knox, P. C.;Palmer, R. B.;Heard, K.;Slattery, J. T.;Dart, R. C.
据报道，酒精中毒患者使用扑热息痛治疗会导致肝功能衰竭。酒精中毒患者的高危期是在停止饮酒后立即发生的。这一时期表现出最大的CYP2E1诱导增加和最低的谷胱甘肽水平。我们的假设是，对新近戒酒的受试者连续3天服用对乙酰氨基酚的最大推荐日剂量不会影响普通肝脏检查。进入两个戒酒中心的成年酒精受试者参加了一项前瞻性的双盲、随机、安慰剂对照试验。受试者随机服用对乙酰氨基酚，每天4g，或连续3天服用安慰剂。这项研究有95%的概率检测到15IU/L的血清ALT差异。共有443名受试者入选：308名受试者(258名完成)接受对乙酰氨基酚治疗，135名受试者(114名完成受试者)接受安慰剂治疗。研究小组在人口统计学、饮酒、营养状况或基线实验室评估方面没有不同。对乙酰氨基酚组和安慰剂组ALT峰值分别为57±45IU/L和55±48IU/L。对表现为ALT升高的受试者、确诊为酒精性肝炎的受试者以及ALT峰值大于200IU/L的受试者进行的亚组分析显示，对乙酰氨基酚组和对照组之间没有统计学差异。出现国际标准化比率增加的一个参与者是安慰剂组。酒精中毒患者连续3天服用最大推荐剂量的对乙酰氨基酚，没有出现血清转氨酶升高或肝损伤的其他指标。对乙酰氨基酚治疗疼痛或发烧3天似乎对新近戒酒的患者是安全的，例如那些正在接受急性医疗护理的患者。
Hepatic failure has been associated with reported therapeutic use of acetaminophen by alcoholic patients. The highest risk period for alcoholic patients is immediately after discontinuation of alcohol intake. This period exhibits the largest increase in CYP2E1 induction and lowest glutathione levels. Our hypothesis was that common liver tests would be unaffected by administration of the maximum recommended daily dosage of acetaminophen for 3 consecutive days to newly-abstinent alcoholic subjects. Adult alcoholic subjects entering two alcohol detoxification centers were enrolled in a prospective double-blind, randomized, placebo-controlled trial. Subjects were randomized to acetaminophen, 4 g/day, or placebo for 3 consecutive days. The study had 95% probability of detecting a 15 IU/L difference in serum ALT. A total of 443 subjects were enrolled: 308 (258 completed) received acetaminophen and 135 subjects (114 completed) received placebo. Study groups did not differ in demographics, alcohol consumption, nutritional status or baseline laboratory assessments. The peak mean ALT activity was 57 ± 45 IU/L and 55 ± 48 IU/L in the acetaminophen and placebo groups, respectively. Subgroup analyses for subjects presenting with an elevated ALT, subjects fulfilling a diagnosis of alcoholic hepatitis and subjects attaining a peak ALT greater than 200 IU/L showed no statistical difference between the acetaminophen and control groups. The one participant developing an increased international normalized ratio was in the placebo group. Alcoholic patients treated with the maximum recommended daily dose of acetaminophen for 3 consecutive days did not develop increases in serum transaminase or other measures of liver injury. Treatment of pain or fever for 3 days with acetaminophen appears safe in newly-abstinent alcoholic patients, such as those presenting for acute medical care.
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影响因子：
2.3
作者：
BADGER, TM;RONIS, MJJ;HAKKAK, R
通讯作者：
HAKKAK, R
DOI：
10.1111/j.1530-0277.1995.tb01516.x
发表时间：
1995-04-01
影响因子：
3.2
作者：
LUCAS, D;MENEZ, C;MENEZ, JF
通讯作者：
MENEZ, JF
影响因子：
25.7
作者：
Oneta, CM;Lieber, CS;Seitz, HK
通讯作者：
Seitz, HK
影响因子：
8
作者：
James, Laura P.;Alonso, Estella M.;Squires, Robert H.
通讯作者：
Squires, Robert H.
影响因子：
158.5
作者：
BRADLEY, JD;BRANDT, KD;RYAN, SI
通讯作者：
RYAN, SI