异甘草酸镁联合乙酰半胱氨酸治疗药物性肝损伤患者血清氧化应激指标的改变

Efficacy of cetylcysteine combined with magnesium isoglycyrrhizinate in treatment of patients with drug-induced liver injuries

目的观察应用异甘草酸镁联合乙酰半胱氨酸治疗药物性肝损伤(DILI)患者血清氧化应激指标的变化。方法采用随机数字表法将100例DILI患者分为观察组50例和对照组50例。给予对照组异甘草酸镁治疗,给予观察组异甘草酸镁联合乙酰半胱氨酸治疗,两组患者均连续治疗4周。检测血清丙二醛(MDA)、超氧化物岐化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、白介素-6(IL-6)和降钙素原(PCT)。结果治疗后,观察组血清总胆红素、天冬氨酸氨基转移酶、丙氨酸氨基转移酶和谷氨酰转肽酶水平分别为(14.2±4.6)μmol/L、(62.9±6.8)U/L、(67.5±6.9)、(54.9±8.9)U/L,显著低于对照组[分别为(21.4±7.3)μmol/L、(90.3±8.4)U/L、(86.4±7.5)U/L、(63.6±6.4),P<0.05];治疗后,观察组血清MDA水平为(4.8±0.7)μmol/L,显著低于对照组[(6.2±1.1)μmol/L,P<0.05],血清SOD和GSH-Px水平分别为(81.5±7.9)U/L和(124.7±9.9)U/L,显著高于对照组[分别为(75.5±8.3)U/L和(92.6±8.7)U/L,P<0.05],血清IL-6和PCT水平分别为(4.2±0.7)pg/L和(0.3±0.1)ng/L,显著低于对照组[分别为(6.6±1.2)pg/L和(0.5±0.1)ng/L,P<0.05]。结论联合应用异甘草酸镁和乙酰半胱氨酸治疗DILI患者,近期效果较好,可有效抑制机体炎症反应和氧化应激反应,改善肝功能,值得临床进一步验证。

Objective The aim of this study was to investigate the efficacy of cetylcysteine combined with magnesium isoglycyrrhizinate in treatment of patients with drug-induced liver injuries(DILI).Methods 100 patients with DILI were randomly divided into observation(n=50)and control group(n=50)in this study.The patients in the control group were treated with magnesium isoglycyrrhizinate,and those in the observation group received acetylcysteine and magnesium isoglycyrrhizinate combination for 4 weeks.Serum malonaldehyde(MDA),superoxide dismutase(SOD),glutathione peroxidase(GSH-Px),interleukin-6(IL-6)and procalcitonin(PCT)levels were assayed in all the patients.Results At the end on the observation,serum bilirubin,aspartate aminotransferase,alanine aminotransferase and glutamic transpeptidase levels in the combination group were(14.2±4.6)μmol/L,(62.9±6.8)U/L,(67.5±6.9)and(54.9±8.9)U/L,significantly lower than[(21.4±7.3)μmol/L,(90.3±8.4)U/L,(86.4±7.5)U/L and(63.6±6.4),respectively,P<0.05]in the control;serum MDA level was(4.8±0.7)μmol/L,much lower than[(6.2±1.1)μmol/L,P<0.05],serum SOD and GSH-Px levels were(81.5±7.9)U/L and(124.7±9.9)U/L,significantly higher than[(75.5±8.3)U/L and(92.6±8.7)U/L,respectively,P<0.05],serum IL-6 and PCT levels were(4.2±0.7)pg/L and(0.3±0.1)ng/L,significantly lower than[(6.6±1.2)pg/L and(0.5±0.1)ng/L,respectively,P<0.05]in the control.Conclusion The combination of magnesium isoglycyrrhizinate and acetylcysteine in treatment of patients with DILI is efficacious for short-term observation,which might be related to the inhibition of inflammatory reaction and oxidative stress.