Therapeutic effects of N-acetylcysteine on patients with chronic severe hepatitis B

Objective:To observe the therapeutic effects of N-acetylcysteine(NAC) injection on the patients with chronic severe hepatitis B(CSHB).Methods:Forty and eight patients with CSHB(total bilirubin,TBil171μmol/L,20%PTA40%) were selected and divided randomly into two groups;treatment group and control group.All the patients received routine combined modality therapy,while 24 patients in the treatment group,based on the routine therapy,received additional treating with NAC injection by a daily dose of 8g for 45 days.The changes of patient's clinical symptoms,liver functions,prothrombin activity(PTA) and adverse drug reaction were observed at 0,15,30 and 45 day during the period of treatment respectively.Results:Ten and one cases of the 48 patients dropped out(5 cases in control group,6 cases in treatment group).The levels of TBil and PTA were improved obviously after treating in the patients of both groups.The decrease of TBil and increase of PTA in the treatment group were better than that of control group,but the differences between two groups had no statistical significance(P0.05).The decrease rate of TBil and increase rate of PTA were significantly higher than that of control group at 45 day during the period of treating(P0.05).The total effective rate was 70.8% in the treatment group and 41.7% in the control group(P0.05).The main adverse reaction of NAC was nausea,vomiting and rash in few patients.Conclusion:It is suggested that NAC could decrease the levels of serum TBil and increase the PTA in the patients with hepatic failure,and NAC has no severe adverse effects during administration.