丁二磺酸腺苷蛋氨酸治疗肝炎后肝硬化患者高胆红素血症的效果观察

Efficacy of ademetionine in treatment of hyperbilirubinemia in patients with posthepatitic cirrhosis

目的观察丁二磺酸腺苷蛋氨酸治疗肝炎后肝硬化患者高胆红素血症的疗效。方法将该院2014-05~2015-11收治的62例肝炎后肝硬化高胆红素血症患者随机分为观察组和对照组,各31例。观察组采用丁二磺酸腺苷蛋氨酸1.0 g,1次/d治疗,对照组采用苦黄注射液30 ml,1次/d治疗。两种注射液均加入5%葡萄糖注射液250 ml稀释后静脉滴注。两组基础治疗均为护肝治疗。观察2周、4周后的疗效。结果治疗2周时,观察组血清总胆红素(TBIL)、直接胆红素(DBIL)、丙氨酸氨基转移酶(ALT)、谷氨酰转肽酶(GGT)水平明显低于对照组,差异有统计学意义(P<0.05),但碱性磷酸酶(ALP)及白蛋白(ALB)水平无明显差异(P>0.05)。治疗4周时,观察组TBIL、DBIL、ALT、GGT、ALP等指标水平明显低于对照组,差异有统计学意义(P<0.01),血清ALB水平高于对照组(P<0.05),且观察组TBIL、DBIL、GGT、ALP下降幅度大于对照组,差异有统计学意义(P<0.05)。结论丁二磺酸腺苷蛋氨酸治疗肝炎后肝硬化患者疗效较好,具有良好的退黄作用,且可改善肝脏的合成功能。

Objective To observe the efficacy of ademetionine in treatment of hyperbilirubinemia in patients with posthepatitic cirrhosis. Methods Sixty-two patients with posthepatitic cirrhosis in our hospital from May 2014 to November 2015 were randomly divided into the observation group（ n = 31） and the control group（ n = 31）. The patients in the observation group received ademetionine 1. 0 g ＋ 5% GS 250 ml,ivgtt,qd,and the patients in the control group were given Traditional Chinese Medicine Kuhuang injection 30 ml ＋ 5% GS 250 ml,ivgtt,qd. Both of the two groups received the conventional liver-protecting treatment. The clinical effects were observed 2 and 4 weeks after the treatment. Results The levels of serum total bilirubin（ TBIL）,direct bilirubin（ DBIL）,alanine aminotransferase（ ALT） and gamma-glutamyl transpeptidase（ GGT） in the observation group were significantly lower than those in the control group（ P〈0. 05） 2 weeks after the treatment,but there were no significant differences in the levels of alkaline phosphatase（ ALP） and albumin（ ALB） between the two groups（ P〉0. 05）. The observation group had lower levels of serum TBIL,DBIL,ALT,GGT and ALP（ P〈0. 01）,but higher ALB（ P〈0. 05） than the control group four weeks after the treatment. The levels of TBIL,DBIL,GGT,and ALP decreased more greatly in the observation group than those in the control group（ P〈0. 05）. Conclusion Ademetionine has the actions of eliminating jaundice and improving liver synthetic function and therefore is effective in the treatment of the patients with posthepaitic cirrhosis.