还原型谷胱甘肽联合熊去氧胆酸治疗早产儿胃肠外营养相关性胆汁淤积症的临床研究

Clinical reduced glutathione combined with ursodesoxycholic acid therapy in premature infants with parenteral nutrition associated cholestasis

目的 观察还原型谷胱甘肽联合熊去氧胆酸治疗早产儿胃肠外营养相关性胆汁淤积（PNAC）的临床疗效与安全性.方法 选择诊断符合PNAC早产儿70例,随机分为2组：对照组和治疗组（每组35例）,对照组常规退黄、护肝和调节肠道菌群等处理,在此基础上,治疗组给予还原型谷胱甘肽（每次25 mg,每天3次）和熊去氧胆酸（8～10 mg·kg-1,每天2次）,治疗14 d.治疗后第7,14 d,观察2组患儿的血中谷丙转氨酶（ALT）、总胆红素（TB）、直接胆红素（DB）、胆汁酸（TAB）和r-谷氨酰转肽酶（r-GGT）的差异.结果治疗7,14 d后,治疗组患者血中的ALT、TB、DB、TAB和 r-GGT明显低于对照组（P＆lt;0.05）.且治疗组未发现不良反应症状.结论 还原型谷胱甘肽联合熊去氧胆酸治疗早产儿胆汁淤积症疗效显著且安全性较好.

To observe the clinical efficacy and safety of reduced glutathione combined with ursodesoxycholic acid in the treatment of the premature infants with parenteral nutrition associated cholestasis （PNAC）. Methods The premature babies with PNAC were selected （n = 70）, and divided them into two groups randomly, the control group and the trial group, each group of 35 cases. The control group was trea- ted with removing jaundice protecting liver and regulation of intestinal flo- ra etc. On this basis, the patients in the trial group were given reduced glutathione （25 mg every time, tid）, and also given ursodeoxycholic acid （8 - 10 mg ~ kg-1, bid） for 14 weeks. After 7 days and 14 days, the difference of blood biochemical indicator in two groups was observed, there involved alanine aminotransferase （ALT） ,total bilirubin （TB）, direct bilirubin（ DB）, total bile acid （ TAB ） and r - glutamyl transpeptid- ase （r- GGT） . Results After 7 days and 14 days,the blood biochemi- cal indices in the trial group （ALT, TB, DB, TAB and r - GGT） was significantly lower than the control group （ P 〈 0. 05 ）. Also there was no adverse reactions found in treatment group. Conclusion The clinical effect of reduced glutathione combined with ursodeoxycholic acid therapy in premature infants with cholestasis was significant, and was tolerance. Key words： reduced glutathione ; ursodesoxycholic acid ; parenteral nutrition associated cholestasis; cholestasis; premature baby