丁二磺酸腺苷蛋氨酸辅助治疗原发性胆汁性胆管炎的临床疗效观察  

Effect of S-adenosyl-L-methionine in patients with primary biliary cholangitis treated with ursodeoxycholic acid

作　　者：杜晓菲[1] 陈杰[1] 任姗[1] 张小丹[1] 黄春洋[1] 单晶[1] DU Xiao-fei;CHEN Jie;REN Shan;ZHANG Xiao-dan;HUANG Chun-yang;SHAN Jing(Department of Immunopathy and Hepatology,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京佑安医院肝病免疫科,北京100069

出　　处：《肝脏》2021年第6期661-663,673,共4页Chinese Hepatology

基　　金：北京市属医院科研培育计划项目(PX2019062)。

摘　　要：目的观察丁二磺酸腺苷蛋氨酸辅助治疗原发性胆汁性胆管炎临床疗效。方法选取2018年1月至2019年12月原发性胆汁性胆管炎初治患者50例,随机分2组,对照组予熊去氧胆酸治疗,观察组予熊去氧胆酸联合丁二磺酸腺苷蛋氨酸治疗,丁二磺酸腺苷蛋氨酸静脉注射两周后改口服治疗,总疗程24周。治疗前及治疗6个月、1年时检测肝功能和肝脏弹性。结果治疗6个月爱媛标准判断疗效,观察组应答为23例(92.0%),显著高于对照组17(68.0%),差异有统计学意义(P=0.034);治疗1年巴塞罗那标准判断疗效,观察组应答为20例(80.0%),高于对照组17(68.0%),但差异无统计学意义(P=0.333),治疗后6个月和1年,观察组肝弹性测定值为[(6.6±2.5)kPa,(6.8±3.0)kPa],低于对照组[(6.8±3.0)kPa,(7.4±2.7)kPa],但差异无统计学意义。两组均无严重不良反应。结论丁二磺酸腺苷蛋氨酸辅助治疗原发性胆汁性胆管炎近期临床效果显著。Objective To investigate the effect of S-Adenosyl-L-Methionine(SAMe)supplementation on liver biochemistry and liver stiffness measurement(LSM)value in patients with primary biliary cholangitis(PBC),treated with Ursodeoxycholic acid(UDCA).Methods The all 50 patients with PBC were enrolled and divided into two groups randomly and averagely.They had received UDCA treatment.The patients in observation group additionally had been treated with SAMe in the dose of 1000 mg daily over a period of 24 weeks.SAMe had been injected intravenously for two weeks and then orally treated.Liver function and LSM were measured before treatment,6 months after treatment and 1 year after treatment.Results The therapeutic effect was judged by Ehime standard after 6 months’treatment.There were 23 cases had response in observation group(92.0%),significantly higher than that in the control group(17 cases,68.0%,P=0.034).The therapeutic effect was judged by Barcelona standard after 1 year treatment.There were 20 cases had response in the treatment group(80.0%),which was higher than that in the control group(17 cases,68.0%),but the difference was not statistically significant(P=0.333).6 months and 1 year after treatment,LSM value in observation group was[(6.6±2.5)kPa,(6.8±3.0)kPa],which was lower than that in control group[(6.8±3.0)kPa,(7.4±2.7)kPa],but the difference was not statistically significant as well.There were no serious adverse reactions in both groups.Conclusion Our study demonstrates a positive effect of adding SAMe to UDCA in patients with PBC in near future.

关 键 词：丁二磺酸腺苷蛋氨酸 原发性胆汁性胆管炎 疗效 

分 类 号：R575.7[医药卫生—消化系统]