熊去氧胆酸治疗原发性胆汁性胆管炎患者疗效及其对血脂水平的影响  

The efficacy of ursodeoxycholic acid in the treatment of patients with primary biliary cholangitis and its effects on lipid levels

作　　者：张新驰 熊雨凡 顾静[1] 李莹莹 魏虹合 李欣忆 李娇娇 甘建和[1] 孙蔚[1] 陈丽[1] ZHANG Xinchi;XIONG Yufan;GU Jing;LI Yingying;WEI Honghe;LI Xinyi;LI Jiaojiao;GAN Jianhe;SUN Wei;CHEN Li(Department of Infectious Diseases,the First Affiliated Hospital of Soochow University,Suzhou 215000,China)

机构地区：[1]苏州大学附属第一医院感染科,江苏苏州215000

出　　处：《胃肠病学和肝病学杂志》2025年第2期254-257,共4页Chinese Journal of Gastroenterology and Hepatology

基　　金：“十三五”国家科技重大专项(2017ZX10203201002-002);苏州市卫生青年骨干人才“全国导师制”培训项目(20210013990014);天晴肝病研究基金(TQGB20210134)。

摘　　要：目的探讨熊去氧胆酸(ursodeoxycholic acid,UDCA)治疗原发性胆汁性胆管炎(primary biliary cholangitis,PBC)和肝硬化患者疗效及对相关血脂水平的影响。方法选取2022年6月至2023年6月苏州大学附属第一医院感染科诊治的PBC患者61例,根据其初诊时有无肝硬化分为胆管炎组(n=37)和肝硬化组(n=24),两组患者均予UDCA连续治疗24周,比较两组患者治疗前后肝功能指标和血脂指标的变化。符合正态分布的计量资料治疗前后组内比较采用配对t检验,组间比较采用独立样本t检验;偏态分布的计量资料治疗前后组内比较采用威尔科克森配对符号秩检验,组间比较采用曼-惠特尼U检验。结果治疗前,肝硬化组患者的TBIL和ALP显著高于胆管炎组,差异有统计学意义(P<0.05);对于两组患者血脂指标比较,差异均无统计学意义(P>0.05)。连续治疗24周后,肝硬化组患者的TBIL、ALT、AST、GGT、ALP均明显低于治疗前水平,差异有统计学意义(P<0.05),肝硬化组患者治疗后血脂指标中的TC、LDH-C明显低于治疗前水平,差异有统计学意义(P<0.05);胆管炎组患者治疗后的ALT、AST、GGT、ALP均明显低于治疗前水平,差异有统计学意义(P<0.05);胆管炎组患者治疗后血脂指标中TC、TG、LDL-C明显低于治疗前水平,差异有统计学意义(P<0.05)。治疗后,胆管炎组的TBIL、AST明显低于肝硬化组,差异有统计学意义(P<0.05),且肝硬化组治疗后的TC和LDL-C显著低于胆管炎组治疗后水平,差异有统计学意义(P<0.05)。结论UDCA对于治疗PBC和肝硬化患者,不仅可以明显改善肝功能损伤和胆汁淤积,而且可以调节血脂代谢,尤其是TC和LDH-C,有效改善脂质代谢紊乱。Objective To investigate the efficacy of ursodeoxycholic acid(UDCA)in the treatment of patients with primary biliary cholangitis(PBC)and liver cirrhosis,as well as its effects on lipid profiles.Methods A total of 61 patients diagnosed with PBC at the Department of Infectious Diseases,the First Affiliated Hospital of Soochow University,between Jun.2022 and Jun.2023 were enrolled.Based on the presence or absence of liver cirrhosis at initial diagnosis,patients were divided into cholangitis group(n=37)and liver cirrhosis group(n=24).Both groups received continuous UDCA treatment for 24 weeks.Changes in liver function and lipid profile parameters before and after treatment were compared between the two groups.Paired t-tests were used for within-group comparisons of normally distributed data,while independent sample t-tests were applied for between-group comparisons.For non-normally distributed data,the Wilcoxon signed-rank test was used for within-group comparisons,and the Mann-Whitney U test was employed for between-group comparisons.Results Before treatment,the liver cirrhosis group exhibited significantly higher levels of TBIL and ALP compared to the cholangitis group(P<0.05).No significant differences were observed in lipid profile parameters between the two groups(P>0.05).After 24 weeks of continuous treatment,TBIL,ALT,AST,GGT,and ALP levels were significantly reduced in liver cirrhosis group compared to pre-treatment levels(P<0.05).Additionally,TC and low-density lipoprotein cholesterol(LDL-C)levels in liver cirrhosis group were significantly lower than pre-treatment levels(P<0.05).In the cholangitis group,ALT,AST,GGT,and ALP levels were significantly reduced after treatment(P<0.05),and TC,TG,and LDL-C levels also showed significant reductions(P<0.05).Post-treatment,the cholangitis group exhibited significantly lower TBIL and AST levels compared to liver cirrhosis group(P<0.05).Meanwhile,the liver cirrhosis group showed significantly lower TC and LDL-C levels compared to the cholangitis group after treat-ment(P

关 键 词：熊去氧胆酸 原发性胆汁性胆管炎 肝硬化 血脂 胆固醇 

分 类 号：R575.7[医药卫生—消化系统]