还原型谷胱甘肽治疗酒精性肝病的研究

Effect of reduced glutathione in Alcoholic liver disease

目的:观察还原型谷胱甘肽(古拉定,香港积华药业)注射剂对酒精性肝病的疗效。方法:酒精性肝病(酒精性脂肪肝、酒精性肝炎、酒精性肝硬化)患者73例随机分为古拉定治疗组38例(古拉定1.2g/d,静滴,疗程1mo),对照组35例(维生素C2g/d,静滴,疗程1mo),分别观察2组治疗1mo后血清谷丙转氨酶(ALT),谷草转氨酶(AST),γ-谷氨酰转肽酶(γ-GT)等肝功能恢复情况和血清Ⅲ型前胶原(PCⅢ),透明质酸(HA)等肝纤维化指标变化情况及症状改善情况。结果:古拉定治疗组降酶总有效率为:94.7％(36/38),对照组总有效率为57.1％(20/35),差异具有显著统计学意义,(P<0.05);古拉定治疗组患者血清PC Ⅲ(116±50μg/L),HA(170±101μg/L)浓度较治疗前PC Ⅲ(241±99μg/L),HA(351±188μg/L)均明显下降,(P<0.05),与对照组相比均有显著性差异,(P<0.05),降低PC Ⅲ,HA总有效率分别为:88.6％和89.2％。与对照组(42.4％,44.1％)相比均有显著性差异(P<0.05)。结论:还原型谷胱甘肽对酒精性肝病患者ALT,AST,γ-GT等转氨酶异常有良好治疗作用,同时可抑制肝纤维化的发展。

AIM: To evaluate the therapeutic effect of reduced glutathione in alcoholic liver disease. METHODS: 73 patients with alcoholic liver disease were randomly divided into the reduced glutathione group (continuously infused with 1.2g reduced glutathione daily for 30 days) or the controt group (continuously infused with 2g vitamin C daily for 30 days). Clinical symptoms and the main indices of hepatic function (ALT, AST, y-GT) and liver fibrosis (PC Ⅲ, HA) were evaluated before and after the treatment. RESULTS: There was significant difference in total effective rate between the reduced glutathione group (94.7%, 36/38) and the control group 57.1%(20/35) (P<0.05). In the reduced glutathione group, PC Ⅲ and HA [(116±50)μ g/L, (170±101)μg/L, respectively] in post-treatment were significant lower than that in pretreatment[(241±99)μ g/L, (351±188)μg/L, respectively] (P<0.05). The effective rate in lowering ALT, PCⅢ, HA in the reduced glutathione group were 94.7%, 88.6%, 89.2%, respectively, which were significant higher than those in the control group (57.1%, 42.4%, 44.1%, respectively) (P<0.05). CONCLUSION: Reduced glutathione has satisfactory therapeutical effect in patierts with alcoholic liver disease which can protect hepatic function and can inhibit the progress of hepatic fibrosis.