论文部分内容阅读
[目的]观察熊去氧胆酸对原发性胆汁淤积型肝硬化(PBC)患者的疗效及对肝功酶谱的影响。[方法]纳入研究的54例PBC患者给予熊去氧胆酸口服治疗,用法为:0.25g/次,3次/d,治疗6个月;观察治疗前、后疗效及治疗1个月、3个月、6个月时丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、γ-谷氨酰转肽酶(GGT)、总胆汁酸(TBA)、总胆红素(TBIL)、直接胆红素(DBIL)变化。[结果]①治疗前患者黄疸、瘙痒、乏力发生率分别为44.44%、46.30%、59.25%;治疗后上述症状发生率分别为16.67%、12.96%、20.37%,与治疗前比较显著改善(χ~2=9.818、14.388、17.040,均P<0.05)。②治疗1个月肝功酶谱即有明显改善,ALT、AST、ALP、GGT、TBA、TBIL、DBIL指标均较治疗前改善明显(均P<0.05);治疗3个月后肝功酶谱仍在持续改善,各指标与治疗前及治疗1个月时较比较均差异有统计学意义(P<0.05);治疗6个月,GGT、ALP仍有明显改善,与治疗3个月时比较均差异有统计学意义(P<0.05),但其余指标改善幅度降低,与3个月时比较均差异无统计学意义(P>0.05)。③采用熊去氧胆酸治疗未见明显不良反应。[结论]熊去氧胆酸治疗PBC,能显著改善患者临床症状,并能持续、有效改善患者的肝功酶谱指标,有助于延缓疾病进展。
[Objective] To observe the curative effect of ursodeoxycholic acid on patients with primary cholestatic cirrhosis (PBC) and its effect on hepatic zymogram. [Method] The 54 PBC patients enrolled in this study were given ursodeoxycholic acid orally, and the usage was 0.25g / time, 3 times / d for 6 months. The therapeutic effect and treatment for 1 month and 3 months were observed. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), γ-glutamyl transpeptidase (GGT), total bile TBA, TBIL and DBIL. [Results] The incidences of jaundice, pruritus and fatigue in patients before treatment were 44.44%, 46.30% and 59.25%, respectively. The incidence of these symptoms were 16.67%, 12.96% and 20.37% respectively after treatment, which was significantly improved compared with those before treatment (χ ~ 2 = 9.818,14.388,17.040, all P <0.05). (2) After 1 month of treatment, hepatic zymogram showed a significant improvement. ALT, AST, ALP, GGT, TBA, TBIL and DBIL indexes improved significantly compared with those before treatment (all P <0.05) (P <0.05). After 6 months of treatment, GGT and ALP still showed significant improvement compared with 3 months after treatment (P <0.05), but the improvement rate of other indexes was lower than that of 3 months (P> 0.05). ③ Ursodeoxycholic acid treatment showed no significant adverse reactions. [Conclusion] Ursodeoxycholic acid treatment of PBC can significantly improve the clinical symptoms of patients, and can continue and effectively improve the patients liver enzyme zymogram, help to delay the disease progression.