Опыт применения гепатопротектора ремаксол в лечении цирроза печени

The objective of the research was to study the effectiveness of including drug remaxol in the scheme of therapy for patients with decompensated cirrhosis of alcoholic etiology. A group of 29 patients with cirrhosis were treated in the ICU due to deterioration caused by growing phenomena of multiple organ failure. All patients received combined therapy depending on the general state. In addition, 12 patients (main group) received remaxol for 3 – 9 days (400 – 800 mL at a rate of 3 mL/min), 17 patients (control group) received essentiale (daily, 5.0 mL/20.0 mL blood of a patient intravenously). The inclusion of remaxol in the scheme of therapy increased the effectiveness of treatment, which was manifested by (i) decreasing severity of liver failure (transition from Class C to B on the Child-Pugh scale), (ii) reducing systemic inflammatory response and multiple organ failure (on the SOFA scale) with reliable half decline to 6.1 ± 1.7 points ( p < 0.05), (iii) arresting pneumonia by the end of treatment in the ICU in 57.2% of patients and shortening ALV to 4.2 ± 0.7 days ( p < 0.05). Owing to this treatment, the condition of all patients has been improved from decompensated to subcompensated, which allowed them to be transferred from ICU to therapy department in shorter time: remaxol group, within 7.5 ± 1.2 day; control group, within 9.4 ± 1.4 day ( p = 0.05). In terms of prognosis and mortality rate (on the SAPS II scale), the state of patients was serious with poor prognosis of cirrhotic process, however, patients treated in the scheme with remaxol showed positive trend with 1.5-fld reduced negative dynamics ( p < 0.05). The obtained data on clinical and laboratory efficacy along with good drug tolerance allow us to recommend the inclusion of remaxol in the scheme of treatment for patients with acute and chronic liver disease.