还原型谷胱甘肽联合双环醇对抗结核药物导致肝损伤患者肝功能和氧化应激反应的影响

Effects of Reduced Glutathione Combined with Bicyclol on Liver Function and Oxidative Stress in Patients with Liver Injury Induced by Anti-Tuberculosis Drugs

目的:探讨还原型谷胱甘肽联合双环醇对抗结核药物导致肝损伤患者肝功能和氧化应激反应的影响。方法:选择2019年1月至2021年5月于该院就诊的抗结核药物导致肝损伤的患者200例,依据随机数字表法分为对照组和治疗组,每组100例。对照组患者采用双环醇治疗,1次25 mg, 1日3次。治疗组患者在对照组的基础上将还原型谷胱甘肽1.8 g加入5%葡萄糖注射液250 mL中,静脉滴注,1日1次。两组患者均连续治疗4周。观察两组患者治疗前后的肝功能指标[血清丙氨酸转氨酶(ALT)、总胆红素(TBIL)和天冬氨酸转氨酶(AST)]、氧化应激指标[丙二醛(MDA)、超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSH-Px)]水平,比较疗效和不良反应发生情况。结果:治疗2、4周后,两组患者血清ALT、TBIL及AST水平,MDA、SOD和GSH-Px水平较治疗前显著改善,治疗组患者治疗后的改善效果较对照组更为明显,差异均有统计学意义(P<0.05)。观察组患者的总有效率为96.00%(96/100),明显高于对照组的76.00%(76/100),差异有统计学意义(P<0.05)。两组患者皮疹、头晕、胃肠道不适和失眠等不良反应发生率的差异无统计学意义(P>0.05)。结论:还原型谷胱甘肽联合双环醇用于抗结核药物导致肝损伤患者的临床疗效显著,能够有效改善肝功能指标,缓解氧化应激反应。

OBJECTIVE:To probe into the effects of reduced glutathione combined with bicyclol on liver function and oxidative stress in patients with liver injury induced by anti-tuberculosis drugs.METHODS:Totally 200 patients with liver injury induced by anti-tuberculosis treatment in the hospital from Jan.2019 to May 2021 were extracted to be divided into the treatment group and control group via the random number table method,with 100 cases in each group.The control group was treated with bicyclol,25 mg for once,tid.On the basis of the treatment group,reduced glutathione was intravenously infused,1.8 g was added to 250 mL of 5%glucose injection,once a day.Both groups were treated for 4 consecutive weeks.The liver function indexes[serum alanine aminotransferase(ALT),total bilirubin(TBIL)and aspartate aminotransferase(AST)]and oxidative stress indexes[malondialdehyde(MDA),superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)]before and after treatment were observed in two groups.The efficacy and adverse drug reactions were compared.RESULTS:After treatment of 2 and 4 weeks,the levels of serum ALT,TBIL and AST,MDA,SOD and GSH-Px in two groups were significantly improved compared with those before treatment,and the improvement in the treatment group was more significant than that in the control group,the differences were statistically significant(P<0.05).The total effective rate of the observation group was 96.00%(96/100),significantly higher than 76.00%(76/100)of the control group,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse drug reactions such as rash,dizziness,gastrointestinal discomfort and insomnia between two groups(P>0.05).CONCLUSIONS:The clinical efficacy of reduced glutathione combined with bicyclol on liver function and oxidative stress in patients with liver injury induced by anti-tuberculosis drugs is significant,which can effectively improve liver function indexes and relieve oxidative stress.