还原型谷胱甘肽对他汀类药物致乙型肝炎标志物阳性患者肝损害的预防作用

Clinical observation of glutathione to reduce hepatic involvement of statin therapy patients with hepatitis B markers positive

目的观察谷胱甘肽（GSH）对他汀类药物致乙型肝炎标志物阳性患者肝损害的预防作用。方法采用他汀类药物治疗的乙型肝炎标志物阳性患者164例随机分为治疗组（82例）和对照组（82例），在应用他汀类药物治疗原发病的同时，对照组采用基础护肝治疗（给予肌苷、维生素C等治疗），治疗组采用还原型谷胱甘肽静脉滴注（1．2g／次，1次／d）。分别于治疗前、治疗后12周检测患者肝功能指标。结果对照组治疗后丙氨酸氨基转移酶、总胆红素、直接胆红素水平较治疗前明显升高（t=2．66、1．98、2．13，均P〈0．05）；治疗组治疗前后各项观察指标水平差异均无统计学意义（均P〉0．05），治疗组治疗后丙氨酸氨基转移酶超过正常值12例（14．6％）、〉3倍正常值上限0例，对照组分别为23例（28．1％）、3例（3．7％），两组差异均有统计学意义（x2=4．672，5．304，均P〈0．05）。结论还原型谷胱甘肽可明显减少他汀类药物致乙型肝炎标志物阳性患者肝损害的发生。

Objective To observe the clinical efficacy of glutathione （GSH） to reduce hepatic involvement of statin therapy patients with hepatitis B markers positive. Methods 164 cases with hepatitis B markers positive were selected and divided into the treatment group （82 cases） and control group （82 cases）. In a statin therapy with primary disease, at the same time,the control group using based protect liver therapy （both inosine, vitamin C ） , the treatment group using reduced glutathione intravenous drip （1.2g, one/d）. After 12 weeks, the liver function was examined. Results Patients taking statins ALT, TB and DB levels obviously higher than before, had a statistically significant difference （t = 2.66,1.98,2.13, P 〈0. 05 ）, the differences of observation index level in treatment group before and after treatment had no statistical difference （P 〉 O. 05 ）, 12 patients （14.6%） ALT level in treatment group were more than normal,0 case more than normal limit 3 times,control group respectively for 23 cases （28. 1% ） ,3 cases （3.7%）, two groups had statistically significant difference （ X^2 = 4. 672,5. 304, all P 〈 0.05）. Conclusion GSH can obviously reduce hepatic involvement of statin therapy patients with hepatitis B markers positive.