异甘草酸镁治疗难治性肾病综合征患者环磷酰胺所致肝损伤的疗效观察

Effect of Magnesium Isoglycyrrhizinate on Treatment of Liver Injury Caused by Cyclophosphamide in Refractory Nephritic Syndrome Patients

目的观察异甘草酸镁对难治性肾病综合征患者环磷酰胺所致肝损伤的临床疗效。方法 63例因环磷酰胺治疗导致肝损伤的难治性肾病综合征患者,按随机数字表法分为治疗组30例和对照组33例。治疗组静脉滴注异甘草酸镁,对照组静脉滴注还原型谷胱甘肽,疗程均为2周。观察治疗前后血清丙氨酸转氨酶(ALT)、谷草转氨酶(AST)、血清总胆红素(TBIL)、血清白蛋白(ALB)、疗效及药物不良反应。结果两组治疗后症状和体征大多数恢复正常,两组乏力、纳差、腹胀、肝区不适、肝肿大复常率比较,差异无统计学意义(P>0.05);两组治疗前血清ALT、AST、TBIL、ALB水平比较,差异无统计学意义(P>0.05);治疗后两组血清ALT、AST、TBIL水平均较治疗前明显降低(P<0.05),但血清ALB水平无明显变化(P>0.05);治疗后治疗组血清ALT、ALB水平明显低于对照组(P<0.05),但治疗后两组血清AST、TBIL水平比较,差异无统计学意义(P>0.05);治疗组总有效率为96.7%,对照组为84.8%,治疗组疗效明显优于对照组(P<0.05);两组均未发生严重不良反应。结论异甘草酸镁对难治性肾病综合征患者环磷酰胺所致肝损伤疗效较好,安全性高。

Objective To explore the effect of magnesium isoglycyrrhizinate on the treatment of liver injury caused by cyclophosphamide in refractory nephritic syndrome patients. Methods Sixty-three refractory nephritic syndrome patients with liver injury caused by cyclophosphamide were divided into treatment group（ 30 cases） and control group（ 33 cases）according to the random number table. The treatment group was treated with the intravenous drip of magnesium isoglycyrrhizinate,and the control group was treated with the intravenous drip of reduced glutathione,the treatment lasted for 2weeks in both groups. The serum glutamic-pyruvic transaminase（ ALT）,glutamic-oxalacetic transaminease（ AST）,total bilirubin（ TBIL） and albumin（ ALB） before and after the treatment as well as therapeutic effects and drug adverse reactions were observed. Results The signs and symptoms of both groups became normal in most of the patients after treatment,the recovery rate of fatigability,anorexia,abdominal distension,discomfort in liver area and hepatomegaly showed no significant difference between two groups（ P〉0. 05）. There was no significant difference in the serum levels of ALT,AST,TBIL,ALB before treatment between two groups（ P〉0. 05）. The serum levels of ALT,AST,TBIL after treatment were significantly lower than those before treatment in both groups（ P〈0. 05）,but the serum level of ALB showed no significant changes（ P〈0. 05）. The serum levels of ALT,ALB of treatment group were significantly lower than those of control group aftertreatment（ P〉0. 05）,but the serum levels of AST,TBIL after treatment showed no significant difference between two groups（ P〉0.05）. The total effective rate was 96. 7% in the treatment group,which was 84. 8% in the control group,the therapeutic effect of treatment group was significantly better than that of control group（ P〈0. 05）. No severe adverse events occurred in both groups. Conclusion Magnesium isoglycyrrhizinate has better effects on the treatment of liver injury caused by cyclophosphamide in refractory nephritic syndrome patients,and it has no severe adverse reactions.