熊去氧胆酸治疗慢性乙肝及肝硬化伴胆汁淤积

Ursodeoxycholic Acid on Patients of Chronic Hepatitis B and Hepatitis B Related Cirrhosis With Cholestasis

目的观察熊去氧胆酸(优思弗)治疗慢性乙肝及肝硬化伴胆汁淤积的疗效及安全性。方法将慢性乙肝及肝硬化伴胆汁淤积患者67例随机分为治疗组35例与对照组32例;治疗组在对照组内科治疗基础上加用优思弗胶囊,每次250 mg,每日3次,疗程12周。结果治疗12周后,优思弗治疗组总有效率为85.7%,显著高于对照组的59.4%(P<0.05);谷丙转氨酶(ALT)从145.5±80.4 U/L下降至47.3±35.6 U/L,总胆红素(TBIL)从96.9±37.2μmol/L下降至37.9±37.5μmol/L,直接胆红素(DBIL)从66.4±27.5μmol/L下降至21.9±26.1μmol/L,总胆汁酸(TBA)从78.7±33.1μmol/L下降至27.7±36.0μmol/L,碱性磷酸酶(ALP)从138.1±30.4 U/L下降至76.5±56.5 U/L,γ-谷氨酰转肽酶(γ-GT)从167.0±44.6 U/L下降至84.3±72.8 U/L,与对照组比较差异有统计学意义(P<0.01或P<0.05)。优思弗治疗组不良反应发生率为5.71%(2/35)。结论优思弗治疗慢性乙肝及肝硬化伴胆汁淤积患者有较好的疗效和安全性。

Objective To assess the efficacy and safty of ursodeoxycholic acid（UDCA）in treatment of chronic hepatitis B and hepatitis B related cirrhosis with intrahepatic cholestasis. Methods Sixty-seven chronic hepatitis B and hepatitis B related cirrhotic patients with cholestasis were randomly divided into the UDCA group（n=35） and the control group（n=32）.The UDCA group was given oral capsule of UDCA,250 mg three times daily for 12 weeks besides basic therapy.The control group was only treated with conventional therapy. Results At the end of the 12th week,the total effective rate in the UDCA group was significantly higher than that in the control group（85.7% vs 59.4%,P〈0.05）.The serum alanine aminotransferase（ALT）,total bilirubin（TBil）,direct bilirubin（DBil）,total bile acid（TBA）,alkaline phosphatase（ALP） and γ-glutamyl transferase（γ-GT） levels in the UDCA group decreased from 145.5±80.4 U/L,96.9±37.2 μmol/L,66.4±27.5 μmol/L,78.7±33.1 μmol/L,138.1±30.4 U/L,167.0±44.6 U/L before the treatment to 47.3±35.6 U/L,37.9±37.5 μmol/L,21.9±26.1 μmol/L,27.7±36.00） μmol/L,76.5±56.5 U/L,84.3±72.8 U/L at week 12 respectively,which were significantly lower than those in the control group at week 12（P〈0.01 or P〈0.05）.The incidence of adverse events in the UDCA group was 5.71%（2/35）. Conclusion UDCA is effective and safe on patients of chronic hepatitis B and hepatitis B related cirrhosis with intrahepatitic cholestasis.