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目的探讨腺苷蛋氨酸联合糖皮质激素治疗药物性胆汁淤积性肝病的临床效果。方法采用随机数字表法将65例药物性胆汁淤积性肝病患者分为观察组(n=33)和对照组(n=32),两组均停用损肝药物,并给予维生素B6、肌苷、还原型谷胱甘肽等常规保肝治疗,观察组加用腺苷蛋氨酸联合糖皮质激素治疗,两组总治疗周期均为4周,比较两组临床效果及不良反应发生率,采用酶联免疫法检测血清碱性磷酸酶(ALP)、丙氨酸氨基转移酶(ALT)、总胆汁酸(TBA)、总胆红素(TBIL)水平。采用SPSS18.0统计软件进行数据处理,P<0.05为差异有统计学意义。结果观察组临床效果优于对照组,两组比较,P<0.05;观察组治疗后ALP、ALT、TBA、TBIL低于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率为9.09%(3/33),对照组不良反应发生率为3.13%(1/32),两组比较,P>0.05。结论腺苷蛋氨酸联合糖皮质激素可显著提高药物性胆汁淤积性肝病的治疗效果。
Objective To investigate the clinical effect of adenosine methionine combined with glucocorticoid in the treatment of drug-induced cholestatic liver disease. Methods Sixty-five patients with drug-induced cholestatic liver disease were divided into observation group (n = 33) and control group (n = 32) by random number table. Both of the two groups were given losartan and vitamin B6 , Reduced glutathione and other conventional hepatoprotective therapy, the observation group plus adenosylmethionine plus glucocorticoid treatment, the two groups were treated for a total of four weeks, the clinical efficacy and adverse reactions were compared between the two groups, the use of enzyme linked Serum ALP, ALT, TBA and TBIL were measured by immunohistochemistry. Using SPSS18.0 statistical software for data processing, P <0.05 for the difference was statistically significant. Results The clinical effect of the observation group was better than that of the control group, P <0.05; the ALP, ALT, TBA and TBIL in the observation group were lower than those in the control group (P <0.05); adverse reactions in the observation group The rate of adverse reactions in the control group was 3.13% (1/32), and the difference was significant (P> 0.05). Conclusions Adenosine methionine combined with glucocorticoids can significantly improve the therapeutic effect of drug-induced cholestatic liver disease.