多烯磷脂酰胆碱治疗抗结核药物所致肝损伤患者疗效研究  

Therapeutic efficacy of polyene phosphatidylcholine in patients with anti-tuberculosis agents-induced liver injury

作　　者：刘云华 笪荣峰 徐湖波 江应平 谢华平 Liu Yunhua;Da Rongfeng;Xu Hubo(Department of Gastroenterology,First People's Hospital Affiliated to Hubei University of Science and Technology,Tianmen 431700,Hubei Province,China)

机构地区：[1]湖北科技学院附属天门市第一人民医院消化内科,湖北省天门市431700 [2]华中科技大学同济医学院附属同济医院消化内科

出　　处：《实用肝脏病杂志》2021年第2期228-231,共4页Journal of Practical Hepatology

摘　　要：目的探讨多烯磷脂酰胆碱治疗抗结核药物所致肝损伤患者的疗效及对血清血红素加氧酶(HO-1)、谷胱甘肽过氧化物酶(GSH-Px)和超氧化物歧化酶(SOD)水平的影响。方法2018年3月~2019年3月我院消化内科诊治的78例肺结核患者在抗结核药物治疗过程中发生肝损伤,采用随机数字表法将所选患者分为对照组39例和观察组39例,在抗涝治疗过程中分别给予甘草酸二铵胶囊或者多烯磷脂胆碱胶囊口服治疗,两组均连续观察12周。采用ELISA法检测血清白细胞介素-6(IL-6)、IL-1β和肿瘤坏死因子-ɑ(TNF-ɑ)水平,采用放射免疫法测定血清HO-1、GSH-Px和SOD水平。结果在观察结束时,观察组血清丙氨酸氨基转移酶(ALT)水平为(28.1±20.5)U/L,显著低于对照组【(59.4±22.7)U/L,P<0.05】,血清天冬氨酸氨基转移酶(AST)水平为(345.1±17.3)U/L,显著低于对照组【(45.1±17.3)U/L,P<0.05】;血清TNF-ɑ水平为(7.4±1.5)pg/mL,显著低于对照组【(10.3±1.8)pg/mL,P<0.05】,血清IL-1β水平为(13.7±2.1)ng/mL,显著低于对照组【(34.2±4.8)ng/mL,P<0.05】;血清HO-1水平为(294.1±16.9)U/L,显著高于对照组【(198.8±17.2)U/L,P<0.05】,血清SOD水平为(544.2±13.3)U/L,显著高于对照组【(421.0±12.8)U/L,P<0.05】。结论应用多烯磷脂酰胆碱治疗抗结核药物所致的肝损伤患者可明显升高血清HO-1和SOD水平,减轻氧化应激反应,可能与疗效较好有关,值得进一步研究。Objective To investigate the therapeutic efficacy of polyene phosphatidylcholine in patients with anti-tuberculosis agents-induced liver injury and its effect on serum heme oxygenase(HO-1),glutathione peroxidase(GSH-Px),and superoxide dismutase(SOD)levels.Methods 78 patients drug-induced liver injury(DILI)during anti-tuberculosis therapy for pulmonary tuberculosis were enrolled in our hospital between March 2018 and March 2019,and were randomly divided into control and observation group with 39 in each,receiving diammonium glycyrrhizinate or polyene phosphatidylcholine orally for 12 weeks.Serum interleukin-6,IL-1βand tumor necrosis factor-α(TNF-ɑ)as well as serum HO-1,GSH-Px and SOD levels were detected.Results At the end of 12 week observation,serum level of alanine aminotransferase(ALT)in the observation group was(28.1±20.5)U/L,which was significantly lower than that in the control group[(59.4±22.7)U/L,P<0.05],and serum level of aspartate aminotransferase(AST)in the observation group was(345.1±17.3)U/L,which was significantly lower than that in the control group[(45.1±17.3)U/L,P<0.05];serum TNF-ɑlevel inthe observation group was(7.4±1.5)pg/mL,which was significantly lower than that in the control group[(10.3±1.8)pg/mL,P<0.05],and serum IL-1βlevel in the observation group was(13.7±2.1)ng/mL,which was significantly lower than that in the control group[(34.2±4.8)ng/mL,P<0.05];serum HO-1 level in the observation group was(294.1±16.9)U/L,which was significantly higher than that in the control group[(198.8±17.2)U/L,P<0.05],and serum level of SOD was(544.2±13.3)U/L,which was significantly higher than that in the control group[(421.0±12.8)U/L,P<0.05].Conclusion The administration of polyene phosphatidylcholine in the treatment of patients with DILI caused by anti-tuberculosis medicine is efficacious,which could significantly increase serum HO-1 and SOD levels,and reduce oxidative stress response,and needs further clinical investigation.

关 键 词：药物性肝损伤 多烯磷脂酰胆碱 甘草酸二铵 血红素加氧酶 超氧化物歧化酶 治疗 

分 类 号：R575[医药卫生—消化系统]