熊去氧胆酸治疗乙型肝炎肝硬化的临床疗效

Effect of Ursodeoxycholi acid on liver cirrhosis with hepatitis B

目的:观察熊去氧胆酸在乙型肝炎肝硬化治疗中的临床疗效。方法:84例乙型肝炎肝硬化患者随机分为治疗组和对照组,分别给予熊去氧胆酸联合还原型谷胱甘肽和茵栀黄联合还原型谷胱甘肽治疗。治疗4周和8周后,观察两治疗方案的临床疗效、肝功能各指标的变化、复常率和Child-pugh-Turcotte(CPT)评分改变。结果:治疗4周和8周后,2组显效率、有效率无明显差异(P>0.05)。与对照组比较,治疗组在治疗4周和8周后γ-谷氨酸转肽酶(γ-GT)、碱性磷酸酶(AKP)和球蛋白(GLO)下降明显(P<0.05);总胆红素(TBIL)和直接胆红素(DBIL)的下降程度无明显差异(P>0.05);丙氨酸氨基转移酶(ALT)在治疗4周时下降程度无差别(P>0.05),治疗8周时仍持续下降(16.3±7.2)U/L,下降程度较对照组明显(P<0.05)。治疗4周时2组肝功能各指标复常率无明显差异(P>0.05);8周时治疗组γ-GT,AKP复常率明显高于对照组(P<0.05)。两组患者在治疗4周和8周时CPT评分变化无差别(P>0.05)。结论:熊去氧胆酸可有效降低乙型肝炎肝硬化患者的γ-GT,AKP和GLO水平,可能与其改善胆道损伤、解除淤胆而保护肝细胞有关。

Objective To evaluate the therapeutic effect of Ursodeoxycholi acid on the treatment of liver cirrhosis with hepatitis B. Methods Eighty-four patients with liver cirrhosis were randomly divided into 2 groups ：42 to the treatment group who were given oral capsules of Ursodeoxycholi acid combined with reduced glutathione, and the other 42 to the control group who received Yinzhihuang intravenously, combined with reduced glutathione. Therapeutic efficacy, liver function and its normalization rate, and score of Child-pugh-Turcotte （ CPT ） were observed after 4 week treatment and 8 week treatment. Results The therapeutic efficacy had no significant difference between the treatment group and the control group （ P 〉 0.05 ）. Compared with the control group, the values of γ- glutamyl transpeptidase （ γ- GT ） , alkaline phosphatase （ AKP ） and globulin （ GLO ） of the treatment group decreased more significantly （ P 〈 0.05 ） , and the normalization rates of γ-GT and AKP in the treatment group was significantly higher than that in the control group at 8 week. The decreased levels of total bilirubin （ TBIL ） and direct bilirubin （DBIL） were not significantly different between the 2 groups （ P 〉 0.05 ）. At 4 week the decrease level of ALT in the 2 groups was similar （ P 〉 0.05 ） , while at 8 week the values of ALT reduced more significantly than that of the control group （ P 〈 0.05 ）. The score of CPT of the 2 groups were not different after 4 week and 8 week treatment （P 〉0.05 ）. Conclusion Ursodeoxycholi acid can obviously decrease the values of ~/-GT, AKP and GLO in liver cirrhosis with hepatitis B, which may be related to Ursodeoxycholi acid relieving the injury of bile duct and enhancing biliary transport.