S-腺苷蛋氨酸对化疗药物性肝损伤防治疗效的观察

Protective Effect of Ademetionine 1,4-butanedisulfonate on Liver Injury Caused by Chemotherapeutic Agents

本研究旨在观察S-腺苷蛋氨酸在白血病抗肿瘤药物肝损伤中的防治作用。回顾性分析了2011年1月到2012年4月期间,接受化疗治疗的62例急性白血病患者保肝药物治疗疗效。根据保肝药物不同分为A组27例及B组35例。A组给予多烯磷脂酰胆碱注射液联用S-腺苷蛋氨酸治疗,B组给予多烯磷脂酰胆碱注射液联用复方甘草酸苷治疗。观察2周后肝功能指标变化。B组5例化疗急性肝损伤患者换用了S-腺苷蛋氨酸作为补救治疗。结果表明,A组保肝治疗后ALT、AST水平显著低于治疗前(P<0.05),无1例(0/27)患者出现急性肝损伤。B组14.29%(5/35)的患者出现了急性肝损伤,换用S-腺苷蛋氨酸治疗后肝功能均在中位时间8(5-14)日得到了良好的恢复。结论:S-腺苷蛋氨酸在防治化疗药物性肝损伤方面效果优于复方甘草酸苷。

The aim of this study was to obselve the protective effect of ademetionine 1, 4-butanedisulfonate on liver injury caused by chemotherapy in patients with leukemia. The clinical data of protective effect were analyzed retrospectively from January 2010 to April 2012. A total of 62 acute leukemia patients were divided into A group （ 27 cases） and B group （35 cases）, the polyene phosphatidyl choline combined with ademetionine or combined with compound glycyrrhizin were given in A and B group, respectively. The changes of liver function were observed after 2 weeks, 5 patients in B group suffered from acute liver injury were treated by ademetionine as rescue therapy. Liver function was compared before and after treatment. The results showed that ALT and AST levels were significantly reduced in A group（ P 〈 0. 05 ）, none of the patients （0/27） suffered from acute liver injury, but 14. 29% （5/35） patients in B group suffered from acute liver injury, and liver function could be recovered by substitution treatment of ademetionine （the median time is 8 days, 5 -14 days）. It is concluded that the protective and therapeutic effect of ademetionine against liver injury caused by chemotherapy in patients with leukemia is better than that of compound glycyrrhizin.