腺苷蛋氨酸治疗慢性乙型肝炎高胆红素血症疗效观察  

Effect of S-Adenosyl-L-methionine (SAMe) on the treatment of chronic hepatitis B with hyperbilirubinemia

作　　者：盛庆寿[1] 张红星[1] 蒋阳昆[1] 涂燕云[1] 陈黎[1] 

机构地区：[1]广西中医学院附属瑞康医院肝胆内科,广西南宁530011

出　　处：《胃肠病学和肝病学杂志》2010年第10期909-910,914,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的观察腺苷蛋氨酸治疗慢性乙型肝炎高胆红素血症的临床疗效及安全性。方法选取符合慢性乙型肝炎诊断标准,血清总胆红素(TBiL)>171.1μmol/L的住院患者62例,随机分为治疗组36例和对照组26例。对照组予常规护肝退黄抗病毒治疗,治疗组在对照组基础上加入注射用丁二磺酸腺苷蛋氨酸1.0 g静滴,疗程为4周。观察患者治疗前后症状变化,治疗2周、4周时TBiL、DBiL、ALT、γGT指标变化。结果治疗4周时,治疗组总有效率94.4%,对照组总有效率80.8%,治疗组总有效率高于对照组(P<0.05);治疗组治疗2周与治疗4周时TBiL、DBiL、ALT均低于对照组(P<0.01,P<0.05);治疗组治疗4周时γGT低于对照组(P<0.01);治疗期间两组病例均未出现皮疹、发热、头晕、头痛等不良反应。结论腺苷蛋氨酸对乙型肝炎高胆红素血症有效,安全性好。Objective To evaluate the efficacy and safety of S-Adenosyl-L-methionine（SAMe） on the treatment of chronic hepatitis B with hyperbilirubinemia.Methods A total of 62 chronic hepatitis B patients with TBiL 171.1 μmol/L were randomly assigned to treatment group and control group.Control group（n =26） were treated with conventional therapy（such as alprostadil,glutathione,PHGF,glycyrrhizin and nucleoside analogues）,while treatment group（n =36） were injected with SAM 1.0 g per day for 4 weeks,in addition to conventional therapy.The patients’symptom and serum TBiL,DBiL,ALT,γGT were evaluated at baseline for treatment and in the 2nd and 4th week.Results By the end of therapy,the total efficiency was 94.4% in treatment group and 80.8% in control group respectively（P 0.05）.Serum TBiL,DBiL and ALT level were lower in treatment group after 2 weeks and 4 weeks therapy（P 0.01,P 0.05）.Serum γGT level in treatment group was lower than that in control group after 4 weeks（P 0.01）.No adverse reaction such as rash,fever,dizziness or headache were found in both groups’patients.Conclusion SAMe is effective and safe for the treatment of chronic hepatitis B with hyperbilirubinemia.

关 键 词：腺苷蛋氨酸 慢性乙型肝炎 高胆红素血症 

分 类 号：R512.62[医药卫生—内科学]