泼尼松联合熊去氧胆酸治疗原发性胆汁性肝硬化伴免疫性肝炎的疗效观察

Observation on Efficacy of Prednisone Combined with Ursodeoxycholic Acid in Treatment of Primary Biliary Cirrhosis Complicated with Autoimmune Hepatitis

目的:探讨泼尼松联合熊去氧胆酸治疗原发性胆汁性肝硬化伴免疫性肝炎的疗效。方法:选取2013年4月至2017年6月黄冈市中心医院收治的原发性胆汁性肝硬化伴免疫性肝炎患者40例,按照随机双盲法分为对照组和观察组,每组20例。对照组患者仅给予熊去氧胆酸治疗,观察组患者给予熊去氧胆酸联合泼尼松治疗。对比观察两组患者的中位治疗时间、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)、球蛋白(GLOB)、免疫球蛋白G(Ig G)及免疫球蛋白M(Ig M)水平的差异。结果:观察组、对照组患者的中位治疗时间分别为11.2、10.3个月。治疗后,观察组患者的ALT、AST、GGT、ALP、GLOB、Ig G及Ig M水平较治疗前明显降低,且观察组患者的ALT、AST、GLOB及Ig G水平明显低于对照组,差异均有统计学意义(P<0.05)。结论:泼尼松联合熊去氧胆酸治疗原发性胆汁性肝硬化伴免疫性肝炎,可有效控制疾病进展,疗效较好。

OBJECTIVE： To probe into the efficacy of prednisone combined with ursodeoxycholic acid in treatment of primary biliary cirrhosis complicated with autoimmune hepatitis. METHODS： 40 patients with primary biliary cirrhosis complicated with autoimmune hepatitis admitted into Huanggang Central Hospital from Apr. 2013 to Jun.2017 were selected and divided into control group and observation group via randomize double-blind,with 40 cases in each. The control group was treated with ursodeoxycholic acid,while the observation group was given prednisone combined with ursodeoxycholic acid. Differences in median treatment time, alanine aminotransferase（ ALT）,aspartate aminotransferase（ AST）, γ-glutamyl transpeptidase（ GGT）, alkaline phosphatase（ ALP）, globulin（ GLOB）,immune globulin G（ Ig G） and immune globulin M（ Ig M） levels between two groups were observed and compared. RESULTS： The median treatment time of observation group and control group were respectively 11. 2 months and 10. 3 months. After treatment,the ALT,AST,GGT,ALP,GLOB,Ig G and Ig M levels of observation group had been significantly decreased than those of before treatment,the ALT,AST,GLOB and Ig G levels of observation group were significantly lower than those of the control group,with statistically significant differences（ P〈0. 05）. CONCLUSIONS： Prednisone combined with ursodeoxycholic acid in treatment of primary biliary cirrhosis complicated with autoimmune hepatitis can effectively control the progression of disease,with remarkable efficacy.