摘要
【摘要】 目的：探讨腺苷蛋氨酸联合糖皮质激素在药物性胆汁淤积性肝病（ CLD）中的临床疗效与可行性。方法：选取 2017年 7月 -2019年 8月笔者所在医院收治的 98例药物性 CLD患者，随机分为观察组与对照组，各 49例，对照组仅给予综合保肝治疗，观察组在此基础上应用腺苷蛋氨酸 +糖皮质激素，观察两组治疗前后肝功能指标，评估临床疗效与用药安全性。结果：两组患者治疗后血清总胆红素（ TBIL）、谷丙转氨酸（ ALT）、谷丙转氨酶（ ALP）、谷氨酰转肽酶（ γ-GT）各项肝功能指标均得到明显纠正，但观察组下降幅度明显大于对照组，差异有统计学意义（ P<0.05）；治疗总有效率为 95.9%，明显高于对照组的 81.6%，差异有统计学意义（ P<0.05）；有 3例（ 6.12%）患者出现轻微不良反应，包括血糖轻度升高、低血钾、电解质紊乱各 1例，对症治疗后症状消失，未出现感染、白细胞升高、上消化道出血等严重不良反应，对照组有 4例（ 8.16%）患者出现轻微不良反应，两组不良反应发生率相似，差异无统计学意义（ P>0.05）。结论：腺苷蛋氨酸联合糖皮质激素是一种安全、有效的用药方案，在保证治疗效果的同时不会增加不良反应，值得在药物性胆汁淤积性肝病中推广使用。
【关键词】 药物性胆汁淤积性肝病； 腺苷蛋氨酸； 糖皮质激素； 临床疗效
[Abstract] Objective: To investigate the clinical efficacy and feasibility of adenosylmethionine combined with glucocorticoid in patients with drug-induced cholestatic liver disease (CLD). Methods: from July 2017 to August 2019, 98 patients with drug-induced CLD were randomly divided into the observation group and the control group, with 49 cases in each group. The control group was only given comprehensive liver protection treatment. On this basis, the observation group was given adenosylmethionine + glucocorticoid to observe the liver function indexes before and after treatment, and to evaluate the clinical efficacy and drug safety. Results: after treatment, the liver function indexes of TBIL, alt, ALP and γ - GT in the two groups were significantly corrected, but the decrease of the observation group was significantly greater than that of the control group (P < 0.05); the total effective rate of the treatment was 95.9%, significantly higher than 81.6% in the control group, and the difference was statistically significant (P < 0.05) Statistical significance (P < 0.05); 3 patients (6.12%) had slight adverse reactions, including slight increase in blood glucose, hypokalemia, electrolyte disorder, 1 case respectively. After symptomatic treatment, symptoms disappeared, no serious adverse reactions such as infection, leukocytosis, upper gastrointestinal hemorrhage, 4 patients (8.16%) in the control group had slight adverse reactions, and the incidence of adverse reactions in the two groups was similar and poor The difference was not statistically significant (P > 0.05). Conclusion: adenosylmethionine combined with glucocorticoid is a safe and effective drug regimen, which can ensure the therapeutic effect without increasing adverse reactions. It is worth popularizing in drug-induced cholestatic liver disease.
出版日期
2020年08月18日（中国期刊网平台首次上网日期，不代表论文的发表时间）
