小剂量糖皮质激素治疗胆汁瘀积型药物性肝炎  

Effect of little dosage glucocorticoids on drug - induced cholestasis hepatitis

作　　者：贾长河[1] 袁媛[1] 刘博伟[1] 兰玲[1] 张昊[1] 于静[1] 

机构地区：[1]河南省人民医院消化科,郑州450003

出　　处：《中国实用医刊》2011年第7期68-69,71,共3页Chinese Journal of Practical Medicine

摘　　要：目的观察糖皮质激素治疗胆汁瘀积型药物性肝炎的疗效。方法选择40例胆汁瘀积型药物性肝炎患者，随机分为两组（对照组和实验组），每组20例。对照组应用传统方法给予保肝降酶治疗，实验组在传统方法治疗基础上给予小剂量糖皮质激素治疗，治疗期间每周监测患者肝功能及不良反应，观察治疗效果。结果治疗2、4、8周后实验组总胆红素、碱性磷酸酶下降水平均显著优于对照组，8周时总胆红素（TBIL）实验组平均降至51μmol／L以下，对照组平均降至102μmol／L以下。2例应用激素治疗效果差，3例停用激素后有轻度反弹，1例治疗6周后发现有激素引起的轻度面颊肥胖，未发现股骨头坏死、消化道出血等其他不良反应。结论应用小剂量糖皮质激素治疗胆汁淤积型药物性肝炎有效，疗效优于传统治疗方法，无严重不良反应。Objective To observe the effect of glucocorticoids on drug - induced cholestasis hepatitis. Methods Forty patients with drug- induced cholestasis hepatitis were randomly divided into experiment group（ n = 20） and control group （ n = 20）. Patients in the control group were treated with routine protective liver therapy, and those in the experiment group received additional a little dosage glucocorticoids as well as routine treatment for the same time. Liver function and side effects were determined and inspected in the treatment period weekly. Results The TBIL and ALP value descended significantly in the experiment group,compared to those in the control group after 2, 4, 8 weeks treatment, separately. TBIL value descended to 51μmol/L hereinafter averagely in the experiment group, and to 102μmoL/L hereinafter in the control group after treatment of 8 week. Two cases were unresponsive to glucocorticoids, three cases brokethrough slightly after with drawing glueoeorticoids, one case appeared mild fat face as a result of glucocorticoids, without other side effect such as the alimentary tract bleeding and osteonecrosis of the femoral head. Conclusions Glueocorticoids has better effect on drug - induced cholestasis hepatitis than the routine therapy,without severe side effect.

关 键 词：药物性肝炎 胆汁瘀积型 糖皮质激素 

分 类 号：R575[医药卫生—消化系统]