不同方案治疗原发性胆汁性肝硬化合并干燥综合征的临床研究  

The clinical observation of different therapeutic strategies in combined primary biliary cirrhosis and Sjoegren syndrome

作　　者：高丽霞[1] 张奉春[1] 王立[1] 张烜[1] 刘斌[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院风湿免疫科,100032

出　　处：《中华内科杂志》2012年第11期851-854,共4页Chinese Journal of Internal Medicine

基　　金：“十一五”国家科技支撑计划（2008BA159B03）;重大新药创制课题（2008ZX09312-016）

摘　　要：目的观察不同方案治疗原发性胆汁性肝硬化（PBC）合并干燥综合征（SS）的疗效。方法选PBC合并SS患者79例，分为3组：单用熊去氧胆酸组（U组，29例）、熊去氧胆酸＋泼尼松龙组（UP组，37例）、熊去氧胆酸＋硫唑嘌呤组（UA组，13例），观察不同治疗方案的疗效。结果3种方案对PBC合并SS患者的乏力、瘙痒均有明显改善，但组间比较差异无统计学意义（P值均〉0．05）；3种方案治疗后ALT、AST、碱性磷酸酶（ALP）、γ-谷氨酰转移酶、TBil、DBil、IgG、IgM均有明显下降，组内比较差异有统计学意义（P值均〈0．05），但组间比较差异无统计学意义（P值均〉0．05）。结论PBC合并SS以肝脏受累为主要表现时应以治疗PBC为主，熊去氧胆酸联合糖皮质激素或硫唑嘌呤治疗未发现优于单用熊去氧胆酸。Objective To investigate the role of different therapeutic regimens in primary biliary cirrhosis （PBC）complicating Sjtigren syndrome （SS）. Methods A total of 79 patients diagnosed as PBC complicating SS were enrolled and randomly divided into three groups： Group U （29 patients ） received ursodeoxycholic acid （UDCA） alone, Group UP （37 patients） received UDCA and prednisolone, Group UA （13 patients） received UDCA and azathioprine. The clinical and laboratory data were collected at 0, 3, 6 and 12 months after treatment. Results Fatigue and pruritus were improved in each group with no difference among them（ P 〉 0. 05 ）. The levels of ALT, AST, alkaline phophatase （ ALP）, gamma-glutamyl transferase （GGT）, TBil, DBil, IgG, and IgM in the three groups were all decreased after treatment（ P 〈 0.05 ）, while there were no statistical differences among the three groups （ P 〉 0. 05 ）. Conclusions The combination therapy of UDCA with prednisolone or azathioprine was not better than UDCA alone. The therapeutic policy of PBC complicating SS involved in the liver should settle PBC mainly.

关 键 词：肝硬化 胆汁性 干燥综合征 熊脱氧胆酸 泼尼松龙 硫唑嘌呤 

分 类 号：R575.2[医药卫生—消化系统]