熊去氧胆酸治疗药物性肝损伤开放对照临床试验  

Ursodeoxycholic acid in the treatment of drug-induced liver injury:an open controlled clinical trial

作　　者：倪鎏达[1] 谢青[2] 李捍卫[3] 韩文科[4] 徐伟民[5] 王琳[1] 谢敬东[2] 许昕[4] 陈晓蓉[5] 徐国光[5] 陈成伟[1] 

机构地区：[1]解放军第八五医院,上海200235 [2]交通大学医学院附属瑞金医院 [3]解放军第三○二医院 [4]北京大学第一医院 [5]复旦大学附属公共卫生中心

出　　处：《肝脏》2009年第4期278-280,共3页Chinese Hepatology

摘　　要：目的观察熊去氧胆酸(UDCA)治疗药物性肝损伤(DILI)的疗效。方法288例临床诊断DILI患者分为2组,治疗组144例采用保肝降酶加UDCA(750mg/d)治疗(A组),对照组144例采用保肝降酶治疗(B组),观察比较2组间临床症状、体征的改善和肝功能生化指标的恢复情况。结果乏力、呕吐症状的改善A组较B组明显(0.0062和0.0344);在生化方面DBil、GGT下降明显优于B组(0.0016和0.0073),优效性检验(B组为对照)TBil、DBil两组差值有明显差异(0.0026和0.0002);在胆汁淤积型和混合型患者中治疗前后的TBil、DBil、GGT差值差异有统计学意义(0.0002、0.0000和0.0008)。结论UDCA可有效治疗DILI,尤其是对那些胆汁淤积型和混合型患者更为合适。Objective To investigate the efficacy and safety of ursodeoxycholic acid （UDCA） in the treatment of drug-induced liver injury （DILl） . Methods Two hundred and eighty eight cases of clinically diagnosed DILI patients were divided into two groups： treatment group with liver-protecting and transaminase-lowering treatment together with UDCA（750 mg/d） treatment （group A）, the control without UDCA （group B）. Comparison between two groups was analyzed in clinical signs, symptoms and biochemical indicators of liver function. Results In the clinical signs and symptoms, such as fatigue, vomiting, group A is more improved than in group B significantly（0. 006 2 and 0. 023 4, respectively）. In the biochemical aspects of liver function DBil, GGT, group A was significantly better than that in group B （0. 001 6 and 0. 007 3, respectively）. There was significant difference in TBil, DBil and GGT before and after treatment in patients with eholestasis and DILI（ （5. 0002, （5. 0000 and 0. （5008, respectively）. Conclusion UDCA is safe and effective in the treatment of DILI, especially for the cholestasis-type and mixed-type.

关 键 词：药物性肝损伤 熊去氧胆酸 

分 类 号：R595.3[医药卫生—内科学]