3种常用改善肝功能药物治疗药物性肝损伤的效果比较

Efficacy of three liver- protecting drugs commonly used in treatment of drug- induced liver injury: a comparative analysis

目的对比3种常用改善肝功能药物治疗药物性肝损伤的效果。方法回顾性分析2012年11月^(-2)015年4月于应城市人民医院治疗的90例药物性肝损伤患者的临床资料,根据治疗用药的不同,分为A、B、C 3组,每组30例。其中A组采用还原型谷胱甘肽治疗,B组采用多烯磷脂酰胆碱注射液治疗,C组患者采用硫普罗宁注射液治疗。对比3组患者治疗效果、药物成本以及不良反应发生率。计量资料多组间比采用方差分析,进一步两两比较采用LSD-t检验;计数资料多组间比较采用χ~2检验。结果A组总有效率为90.0%,明显高于B组(73.3%)和C组(76.7%),差异均有统计学意义(χ~2值分别为2.78、3.75,P值均<0.05)。B组药物成本为(316.12±4.05)元,明显高于A组(235.13±2.90)元和C组(135.21±7.62)元,差异均有统计学意义(P值均<0.01)。3组不良反应发生率比较差异无统计学意义(P>0.05)。结论在药物性肝损伤的临床治疗中,还原型谷胱甘肽较多烯磷脂酰胆碱、硫普罗宁所获效果更为显著,同时成本费用也比较合理,可优先选用该药治疗。

Objective To compare the efficacy of three liver- protecting drugs commonly used in the treatment of drug- induced liver injury. Methods The clinical data of 90 patients with drug- induced liver injury who were treated in Yingcheng People＇s Hospital from November 2012 to April 2015 were analyzed retrospectively,and according to the drugs administered,they were divided into groups A,B,and C,with 30 patients in each group. The patients in groups A,B,and C were treated with reduced glutathione,polyene phosphatidylcholine injection,and tiopronin injection,respectively. The efficacy,drug cost,and incidence of adverse events were compared between the three groups. An analysis of variance was used for comparison of continuous data between multiple groups,and the LSD t- test was used for comparison of continuous data between any two groups; the chi- square test was used for comparison of categorical data between multiple groups.Results Group A had a significantly higher overall response rate than groups B and C（ 90. 0% vs 73. 3% /76. 7%,χ-2= 2. 78 and 3. 75,both P〈0. 05）. Group B had a significantly higher drug cost than groups A and C（ 316. 12 ± 4. 05 RMB vs 235. 13 ± 2. 90 and 135. 21 ±7. 62 RMB,both P〈0. 01）. The incidence of adverse events showed no significant differences between the three groups（ P〈0. 05）. Conclusion In the clinical treatment of drug- induced liver injury,reduced glutathione has better efficacy compared with polyene phosphatidylcholine and tiopronin,as well as a reasonable cost. Therefore,this drug is preferred in the treatment of this disease.