硫酸氨基葡萄糖、硫酸软骨素及双醋瑞因对大骨节病患者肝功能的影响

Effects of glucosamine sulfate,chondroitin sulfate and diacerein on liver function in patients with Kashin-Beck disease

目的探讨硫酸氨基葡萄糖和硫酸软骨素以及新型治疗药物双醋瑞因对大骨节病患者肝功能的影响。方法按照《大骨节病诊断》标准(WS/T 207-2010),2019年在大骨节病重病区选取Ⅰ度和Ⅱ度大骨节病病例共333人,根据年龄、性别和病情分度匹配原则采用随机数字表法分为3组:硫酸氨基葡萄糖组(A组,118人)、硫酸软骨素组(B组,99人)和双醋瑞因组(C组,116人),各治疗180 d。采集用药0、90、180 d时3组患者空腹静脉血,分离血清,生化分析仪检测血清肝功能指标,包括白蛋白(ALB)、碱性磷酸酶(ALP)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、直接胆红素(DBIL)、谷氨酰转肽酶(GGT)、总胆红素(TBIL)、总蛋白(TP)。结果治疗0 d时,3组患者8项肝功能指标比较,差异均无统计学意义(P均>0.05)。治疗90 d时,B组血清GGT水平高于A组(P<0.05);与治疗0 d时比较,3组血清ALB水平均较低,ALP、TBIL水平均较高(P均<0.05),ALB异常表达率均较低(P均<0.001),A组TBIL异常表达率较低(P=0.006)。治疗180 d时,B组血清ALB水平高于A组,血清ALP水平高于A、C组,血清AST水平高于C组(P均<0.05);与治疗90 d时比较,3组血清ALB水平均较高,A、C组血清ALP、ALT、AST水平均较低,B、C组血清GGT水平均较低(P均<0.05);与治疗0 d时比较,3组ALB异常表达率均较高(P均<0.001),而C组ALP异常表达率较低(P=0.031)。结论短期服用3种口服药物均应注意监测肝功能指标ALB、ALP、TBIL,长期服用硫酸软骨素应注意密切监测GGT、ALP及AST水平。

Objective To investigate the effects of glucosamine sulfate,chondroitin sulfate and diacerein on liver function in patients with Kashin-Beck disease.Methods According to the criteria of"Diagnosis of Kashin-Beck Disease"(WS/T 207-2010),333 cases of Kashin-Beck disease were selected from the disease severely affected areas,and randomly divided into 3 groups according to the matching principle of age,gender and disease grading:glucosamine sulfate group(group A,118 cases),chondroitin sulfate group(group B,99 cases)and diacerein group(group C,116 cases),and the patients in each group were treated for 180 days.Fasting venous blood samples were collected from the patients in the three groups at 0,90 and 180 days after treatment.Serum was separated.The biochemical analyzer was used to determine the serum levels of albumin(ALB),alkaline phosphatase(ALP),alanine aminotransferase(ALT),aspartate aminotransferase(AST),direct bilirubin(DBIL),glutamyl transpeptidase(GGT),total bilirubin(TBIL),and total protein(TP)of the three groups of patients.Results There was no difference in the expression levels of 8 liver function indexes between the groups on day 0 of treatment(P>0.05).After 90 days of treatment,the expression level of GGT in group B was higher than that in group A(P<0.05);compared with 0 day of treatment,ALB levels of groups A,B and C were all decreased,ALP and TBIL levels increased(P<0.05),the abnormal expression rate of ALB index decreased in all the three groups(P<0.001),the abnormal expression rate of TBIL index in group A was decreased(P=0.006).After 180 days of treatment,ALB level of group B was higher than that of group A,ALP level of group B was higher than that of groups A and C,and AST level of group B was higher than that of group C(P<0.05);compared with 90 days of treatment,ALB levels of groups A,B and C were all increased,ALP,ALT and AST levels of groups A and C were decreased,GGT levels of groups B and C were decreased(P<0.05);compared with 0 day of treatment,the abnormal expression rate of ALB index increased in all the three groups at 180 days of treatment(P<0.001),and the abnormal expression rate of ALP index decreased in group C(P=0.031).Conclusion The liver function indicators ALB,ALP and TBIL should be monitored when taking the three oral drugs for a short time,especially the GGT,ALP and AST indicators when taking chondroitin sulfate for a long time.