腺苷蛋氨酸联合还原型谷胱甘肽治疗药物性肝损伤患者疗效研究  

Clinical efficacy of adenosylmethionine and reduced glutathione in treating patients with drug-induced liver injury

作　　者：肖露 胡弦 蔡颖珂 梅凡 Xiao Lu;Hu Xian;Cai Yingke(Department of Thoracic Surgery,Union Jiangbei Hospital,Wuhan 430000,Hubei Province,China)

机构地区：[1]武汉市协和江北医院胸外科,430000 [2]武汉市协和江北医院急诊科,430000 [3]武汉市协和江北医院肝胆外科,430000 [4]江汉大学附属武汉市第六医院综合科

出　　处：《实用肝脏病杂志》2022年第1期66-69,共4页Journal of Practical Hepatology

基　　金：武汉市科技局科研基金资助项目(编号:20191210)

摘　　要：目的探讨应用腺苷蛋氨酸与还原型谷胱甘肽联合治疗药物性肝损伤(DILI)患者的疗效。方法2017年10月~2020年10月我院收治的90例DILI患者,被随机分为对照组45例和观察组组45例,分别给予还原型谷胱甘肽或还原型谷胱甘肽联合腺苷蛋氨酸治疗。常规检测血清丙二醛(MDA)、超氧化物岐化酶(SOD)和谷胱甘肽过氧化物酶(GSH-Px)。结果本组患者治疗2~6(3.1±1.4)w,观察组血清ALT、AST和TBIL水平分别为(61.2±8.3)U/L、(54.5±7.4)U/L和(14.4±4.1)μmol/L,显著低于对照组【分别为(86.5±11.5)U/L、(63.1±8.0)U/L和(21.5±5.4)μmol/L,P<0.05】;血清前白蛋白和胆碱酯酶水平分别为(205.5±1.9)mg/L和(5224.1±589.9)u/L,显著高于对照组【分别为(188.5±34.2)mg/L和(4933.9±602.2)u/L,均P<0.05】,而血清总胆汁酸水平为(7.1±1.7)μmol/L,显著低于对照组【(9.5±2.1)μmol/L,P<0.05】;血清丙二醛水平为(4.5±0.7)μmol/L,显著低于对照组【(6.5±0.9)μmol/L,P<0.05】,而血清超氧化物岐化酶和谷胱甘肽过氧化物酶分别为(83.1±7.9)U/L和(125.1±13.7)u/L,显著高于对照组【(75.9±7.2)U/L和(105.5±11.1)u/L,P<0.05】。结论联合应用腺苷蛋氨酸与还原型谷胱甘肽治疗DILI患者近期效果较好,可有效抑制体内炎症反应,改善氧化应激状态和肝功能指标。Objective The aim of this study was to observe the clinical efficacy of adenosylmethionine and reduced glutathione in treating patients with drug-induced liver injury(DILI).Methods 90 patients with DILI were enrolled in our hospital between October 2017 and October 2020,and were randomly divided into control and observation group,with 45 cases in each group.The patients in the control group was treated with reduced glutathione,while those in the observation group was additionally treated with adenosylmethionine at base of reduced glutathione.Serum malondialdehyde(MDA),superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)were routinely detected.Results After two to six(3.1±1.4)week treatment,serum ALT,AST and bilirubin levels in the observation group were(61.2±8.3)U/L,(54.5±7.4)U/L and(14.4±4.1)μmol/L,all significantly lower than[(86.5±11.5)U/L,(63.1±8.0)U/L and(21.5±5.4)μmol/L,respectively,P<0.05]in the control;serum prealbumin and cholinesterase levels were(205.5±1.9)mg/L and(5224.1±589.9)u/L,both significantly higher than[(188.5±34.2)mg/L and(4933.9±602.2)u/L,respectively,P<0.05],while serum total bile acids was(7.1±1.7)μmol/L,significantly lower than[(9.5±2.1)μmol/L,P<0.05]in the control;serum MDA level was(4.5±0.7)μmol/L,significantly lower than[(6.5±0.9)μmol/L,P<0.05],while serum SOD and GSH-Px levels were(83.1±7.9)U/L and(125.1±13.7)u/L,both significantly higher than[(75.9±7.2)U/L and(105.5±11.1)u/L,respectively,P<0.05]in the control group.Conclusion The short-term clinical efficacy of adenosylmethionine and reduced glutathione combination in treatment of patients with DILI is good,which could effectively inhibit inflammatory reactions and oxidative stress,and protect the liver functions.

关 键 词：药物性肝损伤 腺苷蛋氨酸 还原型谷胱甘肽 治疗 

分 类 号：R575[医药卫生—消化系统]