异甘草酸镁治疗难治性肾病综合征患者药物所致肝损伤的临床疗效

Effect of magnesium isoglycyrrhizinate on liver injury induced by drugs in patients with refractory nephrotic syndrome

目的研究异甘草酸镁对难治性肾病综合征患者药物所致肝损伤的临床疗效。方法选择2014年3月—2015年12月在内蒙古林业总医院进行诊治的因治疗药物引起肝损伤的难治性肾病综合征患者86例,按数字法随机分为两组,对照组给予复方甘草酸单胺,观察组给予异甘草酸镁,均治疗2周。分别于治疗前后检测天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、谷氨酰转肽酶(y-GT)、总胆汁酸(TBA)等肝功能指标;并记录患者临床症状和体征的复常情况,临床疗效以及不良反应发生情况。结果治疗前两组AST、ALT、y-GT、TBA比较,差异无显著性;两组治疗后的AST、ALT、y-GT、TBA均明显降低(P<0.05),且观察组的降低程度明显优于对照组(P<0.05);观察组的临床症状和体征改善情况明显优于对照组(P<0.05),且观察组的临床症状和体征复常时间明显短于对照组(P<0.05);观察组有效率为95.35%,明显高于对照组79.07%(P<0.05);两组不良反应发生率相比无明显差异。结论异甘草酸镁能明显改善难治性肾病综合征患者药物所致肝损伤,安全有效,具有较高的临床应用价值。

Objective To investigate the clinical effect of magnesium isoglycyrrhizinate on liver injury induced by drugs in patients with refractory nephrotic syndrome. Methods Totally 86 cases of patients with refractory nephrotic syndrome in Inner Mongolia Forestry General Hospital from March 2014 to December 2015 were selected and divided into two groups randomly, 43 cases in each group. The patients in control group were treated with potenlin, and the patients in observation group were treated with magnesium isoglycyrrhizinate. All patients were treated for 2 weeks. The liver function indexes such as AST, ALT, y-GT, and TBA were detected before and after treatment. The recovery of clinical symptoms and signs of patients, clinical efficacy, and adverse reactions were recorded. Results Before treatment, there were no significant difference of AST, ALT, y-GT, and TBA between the two groups. After treatment, the AST, ALT, y-GT, and TBA in the two groups were significantly lower than before treatment（P 0.05）, and the observation group reduce significantly superior to the control group（P 0.05）. In the observation group, the improvement of clinical symptoms and signs was better than that of the control group（P 0.05） and recovery time of clinical symptoms and signs in the observation group was significantly shorter than that of the control group（P 0.05）. The effective rate of the observation group was 95.35%, significantly higher than that of the control group（P 0.05）. There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion Magnesium can significantly improve the liver injury induced by drugs in patients with refractory nephrotic syndrome, and it is safe and effective, with a high clinical value.