丁二磺酸腺苷蛋氨酸联合熊去氧胆酸治疗新生儿胃肠外营养相关性胆汁淤积症的临床疗效观察  

Clinical observation of ademetionine1,4-butanedisulfonate combined with ursodeoxycholic acid in the treatment of neonatal parenteral nutrition associated cholestasis

作　　者：殷炽龙 YIN Chi-long(Department of Pediatrics,Wuzhou Red Cross Hospital,Wuzhou 543002,China)

机构地区：[1]广西梧州市红十字会医院儿科,543002

出　　处：《中国实用医药》2020年第19期99-101,共3页China Practical Medicine

基　　金：广西卫生和计划生育委员会科研课题(项目编号:Z20180459)。

摘　　要：目的观察丁二磺酸腺苷蛋氨酸联合熊去氧胆酸(UDCA)治疗新生儿胃肠外营养相关性胆汁淤积症(PNAC)的临床疗效。方法100例新生儿PNAC患儿,按入院时间随机分为对照组和观察组,各50例。对照组使用熊去氧胆酸治疗,观察组使用熊去氧胆酸联合注射用丁二磺酸腺苷蛋氨酸治疗。比较两组临床疗效及不良反应发生情况;治疗前及治疗10 d后生化检测指标。结果观察组治疗总有效率90.0%(45/50)高于对照组的70.0%(35/50),差异有统计学意义(P<0.05)。两组在应用注射用丁二磺酸腺苷蛋氨酸、熊去氧胆酸期间,均未发现药物不良反应。治疗10 d后,观察组总胆红素(TBIL)、直接胆红素(DBIL)、丙氨酸氨基转移酶(ALT)、γ-谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)及总胆汁酸(TBA)水平分别为(45.4±10.7)μmol/L、(30.1±7.6)μmol/L、(34.5±10.6)U/L、(47.2±11.5)U/L、(402.1±60.9)U/L、(20.4±9.8)μmol/L,对照组分别为(57.5±13.5)μmol/L、(47.7±9.5)μmol/L、(57.4±12.3)U/L、(78.2±16.9)U/L、(489.7±73.4)U/L、(39.4±22.9)μmol/L,两组TBIL、DBIL、ALT、GGT、ALP、TBA水平均较治疗前下降,且观察组低于对照组,差异有统计学意义(P<0.05)。结论丁二磺酸腺苷蛋氨酸及熊去氧胆酸治疗新生儿PNAC均有一定的临床疗效,且丁二磺酸腺苷蛋氨酸联合熊去氧胆酸治疗新生儿PNAC临床疗效显著,能有效退黄、降酶,且未见不良反应。Objective To observe the clinical efficacy of ademetionine1,4-butanedisulfonate combined with ursodeoxycholic acid(UDCA)in the treatment of neonatal parenteral nutrition associated cholestasis(PNAC).Methods A total of 100 neonate with PNAC were divided into control group and observation group by admission time,with 50 cases in each group.The control group was treated by ursodeoxycholic acid,and the observation group was treated by ursodeoxycholic acid combined with ademetionine1,4-butanedisulfonate for injection.The clinical efficacy,occurrence of adverse reactions,biochemical test indexes before treatment and 10 d after treatment were compared between the two groups.Results The total effective rate of treatment 90.0%(45/50)of the observation group was higher than that of the control group 70.0%(35/50),and the difference was statistically significant(P<0.05).No adverse drug reactions were found in the two groups during medication.10 d after treatment,the levels of total bilirubin(TBIL),direct bilirubin(DBIL),alanine aminotransferase(ALT),γ-glutamyl transpeptidase(GGT),alkaline phosphatase(ALP)and total bile acids(TBA)of the observation group were(45.4±10.7)μmol/L,(30.1±7.6)μmol/L,(34.5±10.6)U/L,(47.2±11.5)U/L,(402.1±60.9)U/L and(20.4±9.8)μmol/L,which were(57.5±13.5)μmol/L,(47.7±9.5)μmol/L,(57.4±12.3)U/L,(78.2±16.9)U/L,(489.7±73.4)U/L and(39.4±22.9)μmol/L of the control group.The levels of TBIL,DBIL,ALT,GGT,ALP and TBA of the two groups were lower than those before treatment,and the observation group was lower than the control group,and the difference was statistically significant(P<0.05).Conclusion Ademetionine1,4-butanedisulfonate and ursodeoxycholic acid have a certain clinical effect in the treatment of neonatal PNAC,and ademetionine1,4-butanedisulfonate combined with ursodeoxycholic acid have a significant clinical effect in the treatment of neonatal PNAC,which can effectively recede jaundice and reduced enzyme with no adverse reactions.

关 键 词：新生儿胃肠外营养相关性胆汁淤积症 丁二磺酸腺苷蛋氨酸 熊去氧胆酸 

分 类 号：R722.1[医药卫生—儿科]