异甘草酸镁与复方甘草酸单胺治疗药物性肝损伤患者疗效比较研究

Comparison of therapeutic efficacy of magnesium isoglycyrrhizinate and compound glycyrrhizin monoamine in treatment of patients with drug-induced liver injury

目的分析比较异甘草酸镁与复方甘草酸单胺治疗药物性肝损伤(DILI)患者的疗效。方法2018年1月~2020年1月我院收治的DILI患者102例,随机分为观察组51例和对照组51例,分别给予异甘草酸镁或复方甘草酸单胺静脉滴注治疗14~28 d。采用放射免疫法检测层粘连蛋白(LN)、透明质酸酶(HA)、Ⅲ型前胶原(PC-Ⅲ)和Ⅳ型胶原(Ⅳ-Col)水平,采用ELISA法检测超氧化物歧化酶(SOD)、一氧化氮(NO)、白介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)。结果治疗后,观察组血清ALT和AST水平分别为(42.7±12.5)U/L和(38.2±9.4)U/L,显著低于对照组【分别为(64.5±21.9)U/L和(55.6±15.2)U/L,P<0.05】;血清HA、PC-Ⅲ和Ⅳ-Col水平分别为(138.2±21.5)mg/L、(85.6±17.4)μg/L和(141.5±16.4)μg/L,显著低于对照组【分别为(182.1±23.9)mg/L、(123.8±19.4)μg/L和(175.4±18.7)μg/L,P<0.05】;血清SOD和NO水平分别为(90.3±10.1)U/L和(79.8±9.3)μmol/L,显著高于对照组【分别为(74.9±8.6)U/L和(54.0±7.9)μmol/L,P<0.05】,而血清IL-6和TNF-α水平分别为(11.2±2.5)pg/mL和(26.4±3.6)ng/L,显著低于对照组【分别为(16.8±2.7)pg/mL和(41.3±5.9)ng/L,P<0.05】。结论应用异甘草酸镁治疗DILI患者临床疗效优于复方甘草酸单胺,可有效改善血生化指标和肝纤维化指标,可能与减轻了机体氧化应激和炎症反应有关。

Objective The aim of this study was to compare the therapeutic efficacy of magnesium isoglycyrrhizinate and compound glycyrrhizin monoamine in treatment of patients with drug-induced liver injury(DILI).Methods A total of 102 patients with DILI were enrolled in our hospital between January 2018 and January 2020,and were randomly divided into observation and control group,with 51 cases in each group.The patients in the observation were treated by intravenous administration of magnesium isoglycyrrhizinate,those in the control were treated by intravenous compound glycyrrhizin monoamine,and the regimen lasted for 14 to 28 days.Serum laminin(LN),hyaluronidase(HA),procollagen-Ⅲ(PC-Ⅲ)and collage type Ⅳ(Ⅳ-Col)were detected by radioimmunoassay.Serum superoxide dismutase(SOD),nitric oxide(NO),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were detected by ELISA.Results At the end of the treatment,serum ALT and AST levels in the observation group were(42.7±12.5)U/L and(38.2±9.4)U/L,both significantly lower than[(64.5±21.9)U/L and(55.6±15.2)U/L,respectively,P<0.05]in the control;serum HA,PC-Ⅲ and IV-Col levels were(138.2±21.5)mg/L,(85.6±17.4)μg/L and(141.5±16.4)μg/L,all significantly lower than[(182.1±23.9)mg/L,(123.8±19.4)μg/L and(175.4±18.7)μg/L,respectively,P<0.05];serum SOD and NO levels were(90.3±10.1)U/L and(79.8±9.3)μmol/L,both significantly higher than[(74.9±8.6)U/L and(54.0±7.9)μmol/L,respectively,P<0.05],while serum IL-6 and TNF-α levels were(11.2±2.5)pg/mL and(26.4±3.6)ng/L,both significantly lower than[(16.8±2.7)pg/mL and(41.3±5.9)ng/L,respectively,P<0.05]in the control.Conclusion The therapeutic efficacy of magnesum isoglycyrrhizinate is promising in dealing with patients with DILI,which could effectively improve serum biochemical indexes normal and alleviate oxidative stress.