双环醇联合多烯磷脂酰胆碱治疗抗结核药物性肝损伤的疗效

Efficacy of bicyclic alcohol combined with polyene phosphatidylcholine in the treatment of liver injury caused by anti-tuberculosis drugs

目的探讨双环醇联合多烯磷脂酰胆碱治疗抗结核药物性肝损伤的疗效。方法前瞻性选取102例抗结核药物性肝损伤患者,按照随机数字表法均分为对照组和观察组。对照组给予多烯磷脂酰胆碱胶囊,观察组给予双环醇联合多烯磷脂酰胆碱胶囊,2组均连续治疗4周。比较2组治疗4周后的临床疗效、肝功能指标、炎症指标、氧化应激指标及抗氧化指标水平;统计2组治疗期间的不良反应发生率。结果治疗4周后,观察组的总有效率显著高于对照组(P<0.05);观察组的血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、γ-谷氨酰转肽酶(γ-GT)、丙二醛(MDA)、白细胞介素-6(IL-6)、肿瘤坏死因子-ɑ(TNF-ɑ)、外周血醌NADH脱氢酶1(NQO1)和外周血血红素加氧酶-1(HO-1)水平均显著低于对照组,差异均有统计学意义(P<0.05);血清超氧化物歧化酶(SOD)和外周血Kelch样ECH相关蛋白1(KEAP1)水平显著高于对照组,差异均有统计学意义(P<0.05)。结论双环醇联合多烯磷脂酰胆碱胶囊可明显减轻抗结核药物性肝损伤患者的炎症反应及氧化应激反应,并能降低外周血NQO1和HO-1水平,升高外周血KEAP1水平,改善肝功能,疗效显著,安全性好。

Objective To investigate the efficacy of bicyclic alcohol combined with polyene phosphatidylcholine in the treatment of liver injury caused by anti-tuberculosis drugs.Methods 102 patients with liver injury induced by anti-tuberculosis drugs were prospectively selected,and divided into control group and observation group according to the random number table method.The control group was given Polyene Phosphatidylcholine Capsules,and the observation group was given bicyclic alcohol combined with Polyene Phosphatidylcholine Capsules.Both groups were treated for 4 consecutive weeks.The clinical efficacy after 4 weeks of treatment,the levels of liver function indexes,inflammation indexes,oxidative stress indexes and antioxidant indexes after 4 weeks of treatment of the 2 groups were compared;and the incidence of adverse reactions during treatment of the 2 groups was counted.Results After 4 weeks of treatment,the total effective rate of the observation group was obviously higher than that of the control group(P<0.05);the levels of serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),γ-glutamyl transpeptidase(γ-GT),malondialdehyde(MDA),interleukin-6(IL-6),tumor necrosis factor-ɑ(TNF-ɑ),peripheral blood quinone NADPH quinone oxidoreductase 1(NQO1)and peripheral blood heme oxygenase-1(HO-1)of the observation group were obviously lower than those of the control group,and the differences were obviously significant(P<0.05);the levels of serum superoxide dismutase(SOD)and peripheral blood Kelch-like ECH-related protein 1(KEAP1)were obviously higher than that of the control group,and the differences were obviously significant(P<0.05).Conclusion Bicyclic alcohol combined with Polyene Phosphatidylcholine Capsules could significantly reduce the inflammatory response and oxidative stress response in patients with anti-tuberculosis drug-induced liver injury,and can reduce the levels of peripheral blood NQO1 and HO-1,increase the level of peripheral blood KEAP1,improve the liver function,and have a significant effect and good safety.