熊去氧胆酸联合腺苷蛋氨酸治疗戊型肝炎合并重度黄疸疗效观察

Clinical observation of Ursodeoxycholic acid combining Ademetionine in treatment of viral hepatitis E patients with severe jaundice

目的探讨熊去氧胆酸联合腺苷蛋氨酸治疗急性戊型肝炎并发重度黄疸的临床疗效。方法97例急性戊型肝炎并发重度黄疸患者随机分为3组:A组32例给予腺苷蛋氨酸1000～1500mg,加入10%葡萄糖注射液250mL中,ivqd;B组34例给予腺苷蛋氨酸1000～1500mg,加入10%葡萄糖注射液250mL中,ivqd,熊去氧胆酸250mg,pobid;C组31例用门冬氨酸钾镁针30mL,加入10%葡萄糖注射液250mL中,iv,qd。3组疗程均为30d。观察患者血清总胆红素(T-BiL)、丙氨酸氨基转移酶(ALT)、碱性磷酸酶(ALP)及γ-谷胺酰转移酶(γ-GT)的变化情况。结果治疗后B组的T-BiL、ALT、ALP及γ-GT均比其他两组低,改善程度好。A组有效率71.88%,B组有效率82.35%,C组有效率61.29%,三组间比较均差异有显著性。结论腺苷蛋氨酸联合熊去氧胆酸治疗急性戊型肝炎并发重度黄疸,在促进黄疸消退、改善肝功能方面两者有协同作用。

OBJECTIVE To observe the efficacy of Ursodeoxycholic acid （Ursofalk） combining Ademetionine （Transmetil） in the treatment of viral hepatitis E patients with severe jaundice. METHODS 97 cases of acute viral hepatitis E with severe jaundice were randomly divided into A, B and C groups. The patients of group A were given Ademetionine 1000 - 1500mg qd. The patients of group B were given Ademetionine 1000 - 1500mg qd and Ursodeoxycholic acid 250mg bid. The patients of group C were given Potassium magnessium aspartape 30mL qd. The duration of treatment was 4 weeks. RESULTS After 4 weeks＇ treatment, the T-BiL, ALT, ALP and γ-GT of Group B patients were lower than that of the other two groups. The total effective rate in the group B was significantly higher than that in group A and group C （85.7 % vs 72.5 % and 51.3 %, P 〈 0.05 and P 〈 0.01）. CONCLUSION Compound Ursodeoxycholic acid plus Ademetionine is effective in the treatment of viral hepatitis E patients with severe jaundice. Treatment of either group was effective, but was more effective for the combined group.